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 $16.98 Median $16.98 Typical High $54.95 | Facility | None | $16.98 | $16.98 | $54.95 |
Aetna Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $24.55 | Professional | None | $16.98 | $16.98 | $24.55 |
AllWays Health Partners Setting Professional Modifier None Typical Low $23.99 Median $147.91 Typical High $147.91 | Professional | None | $23.99 | $147.91 | $147.91 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $43.65 Median $63.10 Typical High $87.10 | Facility | None | $43.65 | $63.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $23.99 Median $23.99 Typical High $33.11 | Professional | None | $23.99 | $23.99 | $33.11 |
Fallon Health Setting Facility Modifier None Typical Low $29.51 Median $38.02 Typical High $87.10 | Facility | None | $29.51 | $38.02 | $87.10 |
Fallon Health Setting Professional Modifier None Typical Low $32.36 Median $38.90 Typical High $54.95 | Professional | None | $32.36 | $38.90 | $54.95 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $23.44 Median $30.90 Typical High $81.28 | Professional | None | $23.44 | $30.90 | $81.28 |
Mass General Brigham Setting Professional Modifier None Typical Low $23.99 Median $147.91 Typical High $147.91 | Professional | None | $23.99 | $147.91 | $147.91 |
United Setting Professional Modifier None Typical Low $15.85 Median $33.88 Typical High $95.50 | Professional | None | $15.85 | $33.88 | $95.50 |
Well Sense Setting Facility Modifier None Typical Low $19.50 Median $26.92 Typical High $39.81 | Facility | None | $19.50 | $26.92 | $39.81 |
Well Sense Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $13.80 | Professional | None | $11.48 | $11.48 | $13.80 |
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 $8.51 Median $8.51 Typical High $12.30 | Professional | 52 · Reduced service | $8.51 | $8.51 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.39 Median $3.39 Typical High $4.90 | Professional | 53 · Discontinued | $3.39 | $3.39 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.51 Median $2.51 Typical High $3.72 | Professional | 55 · Aftercare only | $2.51 | $2.51 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.70 Median $1.70 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.70 | $1.70 | $2.45 |
Where Massachusetts sits
The same service costs 4.1 times more in Wyoming than in Kentucky. 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· 10th of 51
$38.90
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.