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 $12.59 Median $12.59 Typical High $57.54 | Facility | None | $12.59 | $12.59 | $57.54 |
Aetna Setting Professional Modifier None Typical Low $12.59 Median $12.59 Typical High $57.54 | Professional | None | $12.59 | $12.59 | $57.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $25.70 Median $27.54 Typical High $93.33 | Facility | None | $25.70 | $27.54 | $93.33 |
AllWays Health Partners Setting Professional Modifier None Typical Low $11.48 Median $29.51 Typical High $144.54 | Professional | None | $11.48 | $29.51 | $144.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $33.88 Median $42.66 Typical High $57.54 | Facility | None | $33.88 | $42.66 | $57.54 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $19.05 | Professional | None | $18.62 | $18.62 | $19.05 |
Cigna Setting Facility Modifier None Typical Low $15.85 Median $15.85 Typical High $17.38 | Facility | None | $15.85 | $15.85 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $15.85 | Professional | None | $11.48 | $11.48 | $15.85 |
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 $11.22 Median $24.55 Typical High $26.30 | Professional | None | $11.22 | $24.55 | $26.30 |
Health New England Setting Professional Modifier None Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | None | $15.14 | $15.14 | $15.14 |
Mass General Brigham Setting Facility Modifier None Typical Low $25.70 Median $27.54 Typical High $93.33 | Facility | None | $25.70 | $27.54 | $93.33 |
Mass General Brigham Setting Professional Modifier None Typical Low $11.48 Median $29.51 Typical High $144.54 | Professional | None | $11.48 | $29.51 | $144.54 |
United Setting Facility Modifier None Typical Low $13.49 Median $34.67 Typical High $34.67 | Facility | None | $13.49 | $34.67 | $34.67 |
United Setting Professional Modifier None Typical Low $9.55 Median $14.45 Typical High $28.18 | Professional | None | $9.55 | $14.45 | $28.18 |
Well Sense Setting Facility Modifier None Typical Low $22.39 Median $30.20 Typical High $44.67 | Facility | None | $22.39 | $30.20 | $44.67 |
Well Sense Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $21.38 | Professional | None | $17.78 | $17.78 | $21.38 |
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 $6.31 Median $6.31 Typical High $28.84 | Professional | 52 · Reduced service | $6.31 | $6.31 | $28.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $11.48 | Professional | 53 · Discontinued | $2.51 | $2.51 | $11.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.91 Median $1.91 Typical High $8.71 | Professional | 55 · Aftercare only | $1.91 | $1.91 | $8.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.26 Median $1.26 Typical High $5.75 | Professional | 56 · Pre-op care only | $1.26 | $1.26 | $5.75 |
Where Massachusetts sits
The same service costs 5.5 times more in Kansas than in Delaware. 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· 17th of 51
$21.88
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.