How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Need provider-level prices or 24+ months of history? Contact us.
Rates by insurance carrier
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Facility Modifier None Typical Low $23.99 Median $25.12 Typical High $79.43 | Facility | None | $23.99 | $25.12 | $79.43 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $34.67 | Professional | None | $25.12 | $25.12 | $34.67 |
AllWays Health Partners Setting Facility Modifier None Typical Low $45.71 Median $61.66 Typical High $81.28 | Facility | None | $45.71 | $61.66 | $81.28 |
AllWays Health Partners Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $26.30 | Professional | None | $16.60 | $17.78 | $26.30 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $25.12 Median $28.18 Typical High $51.29 | Facility | None | $25.12 | $28.18 | $51.29 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $25.12 Median $39.81 Typical High $147.91 | Professional | None | $25.12 | $39.81 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $52.48 Typical High $107.15 | Facility | None | $32.36 | $52.48 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $25.12 | Professional | None | $25.12 | $25.12 | $25.12 |
Fallon Health Setting Facility Modifier None Typical Low $25.12 Median $33.88 Typical High $56.23 | Facility | None | $25.12 | $33.88 | $56.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $16.60 Median $25.12 Typical High $28.84 | Professional | None | $16.60 | $25.12 | $28.84 |
Health New England Setting Facility Modifier None Typical Low $38.02 Median $77.62 Typical High $173.78 | Facility | None | $38.02 | $77.62 | $173.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $45.71 Median $61.66 Typical High $81.28 | Facility | None | $45.71 | $61.66 | $81.28 |
Mass General Brigham Setting Professional Modifier None Typical Low $16.60 Median $17.78 Typical High $26.30 | Professional | None | $16.60 | $17.78 | $26.30 |
United Setting Professional Modifier None Typical Low $16.60 Median $16.60 Typical High $22.39 | Professional | None | $16.60 | $16.60 | $22.39 |
Well Sense Setting Facility Modifier None Typical Low $18.20 Median $33.11 Typical High $57.54 | Facility | None | $18.20 | $33.11 | $57.54 |
Well Sense Setting Professional Modifier None Typical Low $25.12 Median $25.12 Typical High $33.88 | Professional | None | $25.12 | $25.12 | $33.88 |
4 more rates with less common billing modifiers
A modifier changes what was billed, for example a reduced or repeated service. Each of these modifiers carries under 10% of the published rates for this code. Modifier combinations, and modifiers with fewer than 30 rates for a carrier, are not listed.
| Insurance Carrier | Facility/Professional | Modifier | Typical Low | Median | Typical High |
|---|---|---|---|---|---|
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $12.30 Median $12.30 Typical High $12.88 | Professional | 52 · Reduced service | $12.30 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.01 Median $5.01 Typical High $5.13 | Professional | 53 · Discontinued | $5.01 | $5.01 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.72 Median $3.72 Typical High $3.89 | Professional | 55 · Aftercare only | $3.72 | $3.72 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $2.45 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.45 | $2.45 | $2.57 |
Where Massachusetts sits
The same service costs 1.9 times more in Wyoming than in Arizona. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.
Massachusetts· 37th of 51
$25.12
Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.