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 $8.13 Median $12.59 Typical High $67.61 | Facility | None | $8.13 | $12.59 | $67.61 |
Aetna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $9.33 | Professional | None | $8.13 | $8.13 | $9.33 |
AllWays Health Partners Setting Facility Modifier None Typical Low $20.42 Median $24.55 Typical High $26.92 | Facility | None | $20.42 | $24.55 | $26.92 |
AllWays Health Partners Setting Professional Modifier None Typical Low $8.13 Median $8.71 Typical High $10.23 | Professional | None | $8.13 | $8.71 | $10.23 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $8.13 Median $9.33 Typical High $16.98 | Facility | None | $8.13 | $9.33 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $7.41 Median $14.79 Typical High $35.48 | Facility | None | $7.41 | $14.79 | $35.48 |
Cigna Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Professional | None | $8.13 | $8.13 | $8.13 |
Fallon Health Setting Facility Modifier None Typical Low $8.13 Median $11.22 Typical High $17.38 | Facility | None | $8.13 | $11.22 | $17.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $8.13 Median $8.71 Typical High $9.55 | Professional | None | $8.13 | $8.71 | $9.55 |
Mass General Brigham Setting Facility Modifier None Typical Low $20.42 Median $24.55 Typical High $26.92 | Facility | None | $20.42 | $24.55 | $26.92 |
Mass General Brigham Setting Professional Modifier None Typical Low $8.13 Median $8.71 Typical High $10.23 | Professional | None | $8.13 | $8.71 | $10.23 |
United Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $8.13 | Facility | None | $8.13 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $10.00 | Professional | None | $8.71 | $8.71 | $10.00 |
Well Sense Setting Facility Modifier None Typical Low $9.55 Median $12.02 Typical High $19.05 | Facility | None | $9.55 | $12.02 | $19.05 |
Well Sense Setting Professional Modifier None Typical Low $8.13 Median $8.13 Typical High $10.96 | Professional | None | $8.13 | $8.13 | $10.96 |
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 $4.07 Median $4.07 Typical High $4.27 | Professional | 52 · Reduced service | $4.07 | $4.07 | $4.27 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.62 Median $1.62 Typical High $1.70 | Professional | 53 · Discontinued | $1.62 | $1.62 | $1.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.23 Median $1.23 Typical High $1.29 | Professional | 55 · Aftercare only | $1.23 | $1.23 | $1.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.81 Median $0.81 Typical High $0.85 | Professional | 56 · Pre-op care only | $0.81 | $0.81 | $0.85 |
Where Massachusetts sits
The same service costs 1.9 times more in Wyoming than in Georgia. 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· 21st of 51
$8.71
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.