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 $12.88 Median $12.88 Typical High $58.88 | Facility | None | $12.88 | $12.88 | $58.88 |
Aetna Setting Professional Modifier None Typical Low $12.88 Median $12.88 Typical High $58.88 | Professional | None | $12.88 | $12.88 | $58.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $91.20 | Facility | None | $27.54 | $27.54 | $91.20 |
AllWays Health Partners Setting Professional Modifier None Typical Low $11.48 Median $29.51 Typical High $162.18 | Professional | None | $11.48 | $29.51 | $162.18 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $51.29 | Facility | None | $16.98 | $16.98 | $51.29 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $19.05 Median $25.70 Typical High $25.70 | Professional | None | $19.05 | $25.70 | $25.70 |
Cigna Setting Facility Modifier None Typical Low $16.98 Median $18.62 Typical High $20.42 | Facility | None | $16.98 | $18.62 | $20.42 |
Cigna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $18.62 | Professional | None | $13.49 | $13.49 | $18.62 |
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 $11.48 Median $25.70 Typical High $26.30 | Professional | None | $11.48 | $25.70 | $26.30 |
Health New England Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
Mass General Brigham Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $91.20 | Facility | None | $27.54 | $27.54 | $91.20 |
Mass General Brigham Setting Professional Modifier None Typical Low $11.48 Median $29.51 Typical High $162.18 | Professional | None | $11.48 | $29.51 | $162.18 |
United Setting Facility Modifier None Typical Low $14.45 Median $16.60 Typical High $36.31 | Facility | None | $14.45 | $16.60 | $36.31 |
United Setting Professional Modifier None Typical Low $9.77 Median $15.49 Typical High $28.84 | Professional | None | $9.77 | $15.49 | $28.84 |
Well Sense Setting Facility Modifier None Typical Low $22.91 Median $30.90 Typical High $44.67 | Facility | None | $22.91 | $30.90 | $44.67 |
Well Sense Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | None | $18.20 | $18.20 | $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 $6.46 Median $6.46 Typical High $29.51 | Professional | 52 · Reduced service | $6.46 | $6.46 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.51 Median $2.51 Typical High $11.75 | Professional | 53 · Discontinued | $2.51 | $2.51 | $11.75 |
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 $1.29 Median $1.29 Typical High $5.89 | Professional | 56 · Pre-op care only | $1.29 | $1.29 | $5.89 |
Where Massachusetts sits
The same service costs 2.8 times more in Hawaii than in Pennsylvania. 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· 20th of 51
$21.38
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.