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 $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
Aetna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $12.88 | Professional | None | $9.77 | $9.77 | $12.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $17.38 Median $50.12 Typical High $50.12 | Facility | None | $17.38 | $50.12 | $50.12 |
AllWays Health Partners Setting Professional Modifier None Typical Low $7.08 Median $15.85 Typical High $17.38 | Professional | None | $7.08 | $15.85 | $17.38 |
Cigna Setting Facility Modifier None Typical Low $14.13 Median $14.13 Typical High $14.13 | Facility | None | $14.13 | $14.13 | $14.13 |
Cigna Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $16.60 | Professional | None | $12.02 | $12.02 | $16.60 |
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 $7.08 Median $16.98 Typical High $17.78 | Professional | None | $7.08 | $16.98 | $17.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $17.38 Median $50.12 Typical High $50.12 | Facility | None | $17.38 | $50.12 | $50.12 |
Mass General Brigham Setting Professional Modifier None Typical Low $7.08 Median $15.85 Typical High $17.38 | Professional | None | $7.08 | $15.85 | $17.38 |
United Setting Professional Modifier None Typical Low $7.08 Median $10.72 Typical High $17.78 | Professional | None | $7.08 | $10.72 | $17.78 |
Well Sense Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $4.79 Median $4.79 Typical High $6.46 | Professional | 52 · Reduced service | $4.79 | $4.79 | $6.46 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.95 Median $1.95 Typical High $2.57 | Professional | 53 · Discontinued | $1.95 | $1.95 | $2.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.45 Median $1.45 Typical High $1.95 | Professional | 55 · Aftercare only | $1.45 | $1.45 | $1.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.98 Median $0.98 Typical High $1.29 | Professional | 56 · Pre-op care only | $0.98 | $0.98 | $1.29 |
Where Massachusetts sits
The same service costs 2.7 times more in North Dakota than in Ohio. 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· 21st of 51
$14.13
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.