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 $3.72 Median $3.72 Typical High $3.72 | Facility | None | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier None Typical Low $3.72 Median $3.72 Typical High $7.08 | Professional | None | $3.72 | $3.72 | $7.08 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.16 Median $4.90 Typical High $117.49 | Professional | None | $3.16 | $4.90 | $117.49 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $8.32 | Professional | None | $8.32 | $8.32 | $8.32 |
Cigna Setting Professional Modifier None Typical Low $3.39 Median $3.39 Typical High $4.47 | Professional | None | $3.39 | $3.39 | $4.47 |
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 $7.94 | Professional | None | $3.16 | $7.08 | $7.94 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.16 Median $4.90 Typical High $117.49 | Professional | None | $3.16 | $4.90 | $117.49 |
United Setting Professional Modifier None Typical Low $2.69 Median $4.07 Typical High $7.94 | Professional | None | $2.69 | $4.07 | $7.94 |
Well Sense Setting Facility Modifier None Typical Low $5.13 Median $7.08 Typical High $10.72 | Facility | None | $5.13 | $7.08 | $10.72 |
Well Sense Setting Professional Modifier None Typical Low $6,456.54 Median $6,456.54 Typical High $7,762.47 | Professional | None | $6,456.54 | $6,456.54 | $7,762.47 |
5 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 $1.86 Median $1.86 Typical High $2.95 | Professional | 52 · Reduced service | $1.86 | $1.86 | $2.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.76 Median $0.76 Typical High $1.17 | Professional | 53 · Discontinued | $0.76 | $0.76 | $1.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.82 Median $2.82 Typical High $4.37 | Professional | 54 · Surgery only | $2.82 | $2.82 | $4.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.56 Median $0.56 Typical High $0.87 | Professional | 55 · Aftercare only | $0.56 | $0.56 | $0.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.37 Median $0.37 Typical High $0.59 | Professional | 56 · Pre-op care only | $0.37 | $0.37 | $0.59 |
Where Massachusetts sits
The same service costs 3.2 times more in Rhode Island than in New York. 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· 38th of 51
$4.47
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.