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 $3.47 Median $3.47 Typical High $15.85 | Facility | None | $3.47 | $3.47 | $15.85 |
Aetna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $15.85 | Professional | None | $3.47 | $3.47 | $15.85 |
AllWays Health Partners Setting Facility Modifier None Typical Low $7.59 Median $7.94 Typical High $25.12 | Facility | None | $7.59 | $7.94 | $25.12 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.16 Median $8.13 Typical High $53.70 | Professional | None | $3.16 | $8.13 | $53.70 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $9.33 Median $12.02 Typical High $15.85 | Facility | None | $9.33 | $12.02 | $15.85 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $5.25 Median $6.92 Typical High $6.92 | Professional | None | $5.25 | $6.92 | $6.92 |
Cigna Setting Facility Modifier None Typical Low $4.68 Median $5.13 Typical High $5.62 | Facility | None | $4.68 | $5.13 | $5.62 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $3.80 Typical High $5.25 | Professional | None | $3.80 | $3.80 | $5.25 |
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 $3.16 Median $7.08 Typical High $7.24 | Professional | None | $3.16 | $7.08 | $7.24 |
Health New England Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Mass General Brigham Setting Facility Modifier None Typical Low $7.59 Median $7.94 Typical High $25.12 | Facility | None | $7.59 | $7.94 | $25.12 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.16 Median $8.13 Typical High $53.70 | Professional | None | $3.16 | $8.13 | $53.70 |
Tufts Setting Professional Modifier None Typical Low $5.50 Median $6.31 Typical High $6.92 | Professional | None | $5.50 | $6.31 | $6.92 |
United Setting Facility Modifier None Typical Low $4.79 Median $5.37 Typical High $10.96 | Facility | None | $4.79 | $5.37 | $10.96 |
United Setting Professional Modifier None Typical Low $2.63 Median $4.27 Typical High $7.76 | Professional | None | $2.63 | $4.27 | $7.76 |
Well Sense Setting Facility Modifier None Typical Low $6.31 Median $8.32 Typical High $12.30 | Facility | None | $6.31 | $8.32 | $12.30 |
Well Sense Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.89 | Professional | None | $4.90 | $4.90 | $5.89 |
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 $1.74 Median $1.74 Typical High $7.94 | Professional | 52 · Reduced service | $1.74 | $1.74 | $7.94 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.71 Median $0.71 Typical High $3.24 | Professional | 53 · Discontinued | $0.71 | $0.71 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.52 Median $0.52 Typical High $2.40 | Professional | 55 · Aftercare only | $0.52 | $0.52 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.35 Median $0.35 Typical High $1.58 | Professional | 56 · Pre-op care only | $0.35 | $0.35 | $1.58 |
Where Massachusetts sits
The same service costs 3.2 times more in Hawaii 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· 14th of 51
$6.61
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.