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 $11.48 Median $11.48 Typical High $52.48 | Facility | None | $11.48 | $11.48 | $52.48 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $52.48 | Professional | None | $11.48 | $11.48 | $52.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $19.05 Median $25.12 Typical High $81.28 | Facility | None | $19.05 | $25.12 | $81.28 |
AllWays Health Partners Setting Professional Modifier None Typical Low $9.77 Median $26.92 Typical High $131.83 | Professional | None | $9.77 | $26.92 | $131.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $32.36 Median $40.74 Typical High $54.95 | Facility | None | $32.36 | $40.74 | $54.95 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $17.38 | Professional | None | $16.98 | $16.98 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $13.49 Median $13.49 Typical High $15.14 | Facility | None | $13.49 | $13.49 | $15.14 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $13.49 | Professional | None | $9.77 | $9.77 | $13.49 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $8.91 Median $22.39 Typical High $23.99 | Professional | None | $8.91 | $22.39 | $23.99 |
Health New England Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $12.59 | Professional | None | $12.59 | $12.59 | $12.59 |
Mass General Brigham Setting Facility Modifier None Typical Low $19.05 Median $25.12 Typical High $81.28 | Facility | None | $19.05 | $25.12 | $81.28 |
Mass General Brigham Setting Professional Modifier None Typical Low $9.77 Median $26.92 Typical High $131.83 | Professional | None | $9.77 | $26.92 | $131.83 |
United Setting Facility Modifier None Typical Low $7.94 Median $9.77 Typical High $26.92 | Facility | None | $7.94 | $9.77 | $26.92 |
United Setting Professional Modifier None Typical Low $8.71 Median $13.18 Typical High $25.12 | Professional | None | $8.71 | $13.18 | $25.12 |
Well Sense Setting Facility Modifier None Typical Low $20.42 Median $26.92 Typical High $40.74 | Facility | None | $20.42 | $26.92 | $40.74 |
Well Sense Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $19.50 | Professional | None | $16.22 | $16.22 | $19.50 |
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 $5.75 Median $5.75 Typical High $26.30 | Professional | 52 · Reduced service | $5.75 | $5.75 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $10.47 | Professional | 53 · Discontinued | $2.29 | $2.29 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $7.94 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $5.25 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $5.25 |
Where Massachusetts sits
The same service costs 2.5 times more in Arkansas than in Kansas. 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· 12th of 51
$17.38
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.