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 $6.17 Median $6.17 Typical High $28.18 | Facility | None | $6.17 | $6.17 | $28.18 |
Aetna Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $28.18 | Professional | None | $6.17 | $6.17 | $28.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $11.22 Median $13.18 Typical High $43.65 | Facility | None | $11.22 | $13.18 | $43.65 |
AllWays Health Partners Setting Professional Modifier None Typical Low $5.50 Median $14.13 Typical High $74.13 | Professional | None | $5.50 | $14.13 | $74.13 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $8.13 Median $8.13 Typical High $24.55 | Facility | None | $8.13 | $8.13 | $24.55 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $9.12 Median $12.30 Typical High $12.30 | Professional | None | $9.12 | $12.30 | $12.30 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $8.13 | Facility | None | $7.08 | $7.08 | $8.13 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $7.24 | Professional | None | $5.25 | $5.25 | $7.24 |
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 $5.50 Median $12.30 Typical High $12.30 | Professional | None | $5.50 | $12.30 | $12.30 |
Health New England Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Mass General Brigham Setting Facility Modifier None Typical Low $11.22 Median $13.18 Typical High $43.65 | Facility | None | $11.22 | $13.18 | $43.65 |
Mass General Brigham Setting Professional Modifier None Typical Low $5.50 Median $14.13 Typical High $74.13 | Professional | None | $5.50 | $14.13 | $74.13 |
United Setting Facility Modifier None Typical Low $6.31 Median $7.94 Typical High $15.14 | Facility | None | $6.31 | $7.94 | $15.14 |
United Setting Professional Modifier None Typical Low $4.68 Median $6.92 Typical High $12.59 | Professional | None | $4.68 | $6.92 | $12.59 |
Well Sense Setting Facility Modifier None Typical Low $10.96 Median $14.45 Typical High $21.38 | Facility | None | $10.96 | $14.45 | $21.38 |
Well Sense Setting Professional Modifier None Typical Low $8.71 Median $8.71 Typical High $10.47 | Professional | None | $8.71 | $8.71 | $10.47 |
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 $3.09 Median $3.09 Typical High $14.13 | Professional | 52 · Reduced service | $3.09 | $3.09 | $14.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.23 Median $1.23 Typical High $5.62 | Professional | 53 · Discontinued | $1.23 | $1.23 | $5.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.91 Median $0.91 Typical High $4.17 | Professional | 55 · Aftercare only | $0.91 | $0.91 | $4.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.62 Median $0.62 Typical High $2.82 | Professional | 56 · Pre-op care only | $0.62 | $0.62 | $2.82 |
Where Massachusetts sits
The same service costs 3.5 times more in Montana than in Kansas. 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
$10.72
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.