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 $4.27 Median $7.24 Typical High $32.36 | Facility | None | $4.27 | $7.24 | $32.36 |
Aetna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.47 | Professional | None | $4.27 | $4.27 | $4.47 |
AllWays Health Partners Setting Facility Modifier None Typical Low $7.76 Median $10.72 Typical High $14.13 | Facility | None | $7.76 | $10.72 | $14.13 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $5.62 | Professional | None | $4.27 | $5.01 | $5.62 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $4.27 Median $4.90 Typical High $8.91 | Facility | None | $4.27 | $4.90 | $8.91 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $7.59 | Professional | None | $4.27 | $4.27 | $7.59 |
Cigna Setting Facility Modifier None Typical Low $5.50 Median $8.91 Typical High $18.62 | Facility | None | $5.50 | $8.91 | $18.62 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $4.27 | Professional | None | $4.27 | $4.27 | $4.27 |
Fallon Health Setting Facility Modifier None Typical Low $4.27 Median $5.62 Typical High $6.61 | Facility | None | $4.27 | $5.62 | $6.61 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $5.25 | Professional | None | $4.27 | $5.01 | $5.25 |
Mass General Brigham Setting Facility Modifier None Typical Low $7.76 Median $10.72 Typical High $14.13 | Facility | None | $7.76 | $10.72 | $14.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $4.27 Median $5.01 Typical High $5.62 | Professional | None | $4.27 | $5.01 | $5.62 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $6.46 | Professional | None | $5.01 | $5.01 | $6.46 |
Well Sense Setting Facility Modifier None Typical Low $5.25 Median $6.46 Typical High $10.00 | Facility | None | $5.25 | $6.46 | $10.00 |
Well Sense Setting Professional Modifier None Typical Low $4.27 Median $4.27 Typical High $5.75 | Professional | None | $4.27 | $4.27 | $5.75 |
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 $2.14 Median $2.14 Typical High $2.24 | Professional | 52 · Reduced service | $2.14 | $2.14 | $2.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $0.85 Typical High $0.89 | Professional | 53 · Discontinued | $0.85 | $0.85 | $0.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.65 Typical High $0.68 | Professional | 55 · Aftercare only | $0.65 | $0.65 | $0.68 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.43 Typical High $0.45 | Professional | 56 · Pre-op care only | $0.43 | $0.43 | $0.45 |
Where Massachusetts sits
The same service costs 5.1 times more in Wyoming than in Alabama. 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· 13th of 51
$5.01
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.