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 $6.46 Median $6.46 Typical High $6.46 | Facility | None | $6.46 | $6.46 | $6.46 |
Aetna Setting Professional Modifier None Typical Low $6.46 Median $6.46 Typical High $6.46 | Professional | None | $6.46 | $6.46 | $6.46 |
AllWays Health Partners Setting Facility Modifier None Typical Low $47.86 Median $50.12 Typical High $63.10 | Facility | None | $47.86 | $50.12 | $63.10 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4.68 Median $11.75 Typical High $63.10 | Professional | None | $4.68 | $11.75 | $63.10 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $100.00 Median $112.20 Typical High $112.20 | Professional | None | $100.00 | $112.20 | $112.20 |
Cigna Setting Facility Modifier None Typical Low $9.33 Median $9.33 Typical High $9.33 | Facility | None | $9.33 | $9.33 | $9.33 |
Cigna Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $9.33 | Professional | None | $6.76 | $6.76 | $9.33 |
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 $4.68 Median $13.18 Typical High $32.36 | Professional | None | $4.68 | $13.18 | $32.36 |
Health New England Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | None | $34.67 | $34.67 | $34.67 |
Mass General Brigham Setting Facility Modifier None Typical Low $47.86 Median $50.12 Typical High $63.10 | Facility | None | $47.86 | $50.12 | $63.10 |
Mass General Brigham Setting Professional Modifier None Typical Low $4.68 Median $11.75 Typical High $63.10 | Professional | None | $4.68 | $11.75 | $63.10 |
United Setting Professional Modifier None Typical Low $4.68 Median $7.08 Typical High $12.88 | Professional | None | $4.68 | $7.08 | $12.88 |
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 $3.24 Median $3.24 Typical High $3.24 | Professional | 52 · Reduced service | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.29 Median $1.29 Typical High $1.29 | Professional | 53 · Discontinued | $1.29 | $1.29 | $1.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.95 Median $0.95 Typical High $0.95 | Professional | 55 · Aftercare only | $0.95 | $0.95 | $0.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.65 Median $0.65 Typical High $0.65 | Professional | 56 · Pre-op care only | $0.65 | $0.65 | $0.65 |
Where Massachusetts sits
The same service costs 39.8 times more in New York than in Hawaii. 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· 9th of 51
$11.75
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.