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 $8.51 Median $8.51 Typical High $8.51 | Facility | None | $8.51 | $8.51 | $8.51 |
Aetna Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $12.02 | Professional | None | $8.51 | $8.51 | $12.02 |
AllWays Health Partners Setting Facility Modifier None Typical Low $11.22 Median $12.30 Typical High $114.82 | Facility | None | $11.22 | $12.30 | $114.82 |
AllWays Health Partners Setting Professional Modifier None Typical Low $7.41 Median $20.89 Typical High $93.33 | Professional | None | $7.41 | $20.89 | $93.33 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $28.84 Median $33.88 Typical High $44.67 | Facility | None | $28.84 | $33.88 | $44.67 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $22.39 Median $24.55 Typical High $42.66 | Professional | None | $22.39 | $24.55 | $42.66 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $20.89 Typical High $21.38 | Facility | None | $20.89 | $20.89 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $21.38 | Professional | None | $15.49 | $15.49 | $21.38 |
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 $6.31 Median $16.60 Typical High $40.74 | Professional | None | $6.31 | $16.60 | $40.74 |
Health New England Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Health New England Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $28.84 | Professional | None | $13.80 | $13.80 | $28.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $11.22 Median $12.30 Typical High $114.82 | Facility | None | $11.22 | $12.30 | $114.82 |
Mass General Brigham Setting Professional Modifier None Typical Low $7.41 Median $20.89 Typical High $93.33 | Professional | None | $7.41 | $20.89 | $93.33 |
United Setting Professional Modifier None Typical Low $6.31 Median $9.55 Typical High $16.60 | Professional | None | $6.31 | $9.55 | $16.60 |
Well Sense Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $19.95 | Facility | None | $19.95 | $19.95 | $19.95 |
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 $4.27 Median $4.27 Typical High $4.57 | Professional | 52 · Reduced service | $4.27 | $4.27 | $4.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.70 Median $1.70 Typical High $1.82 | Professional | 53 · Discontinued | $1.70 | $1.70 | $1.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.26 Median $1.26 Typical High $1.35 | Professional | 55 · Aftercare only | $1.26 | $1.26 | $1.35 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.85 Median $0.85 Typical High $0.91 | Professional | 56 · Pre-op care only | $0.85 | $0.85 | $0.91 |
Where Massachusetts sits
The same service costs 6.2 times more in Wyoming than in North Carolina. 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· 4th of 51
$20.89
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.