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 $2.45 Median $2.45 Typical High $2.45 | Facility | None | $2.45 | $2.45 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $2.45 Median $2.45 Typical High $4.57 | Professional | None | $2.45 | $2.45 | $4.57 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.09 Median $3.31 Typical High $89.13 | Professional | None | $2.09 | $3.31 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $2.24 Median $2.24 Typical High $2.95 | Professional | None | $2.24 | $2.24 | $2.95 |
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 $2.09 Median $4.68 Typical High $5.25 | Professional | None | $2.09 | $4.68 | $5.25 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.09 Median $3.31 Typical High $89.13 | Professional | None | $2.09 | $3.31 | $89.13 |
United Setting Professional Modifier None Typical Low $1.78 Median $2.69 Typical High $5.25 | Professional | None | $1.78 | $2.69 | $5.25 |
Well Sense Setting Facility Modifier None Typical Low $3.55 Median $4.90 Typical High $7.24 | Facility | None | $3.55 | $4.90 | $7.24 |
Well Sense Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $12.59 | Professional | None | $10.47 | $10.47 | $12.59 |
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 $1.23 Median $1.23 Typical High $1.95 | Professional | 52 · Reduced service | $1.23 | $1.23 | $1.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.50 Median $0.50 Typical High $0.78 | Professional | 53 · Discontinued | $0.50 | $0.50 | $0.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.86 Median $1.86 Typical High $2.95 | Professional | 54 · Surgery only | $1.86 | $1.86 | $2.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.37 Median $0.37 Typical High $0.59 | Professional | 55 · Aftercare only | $0.37 | $0.37 | $0.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.25 Median $0.25 Typical High $0.39 | Professional | 56 · Pre-op care only | $0.25 | $0.25 | $0.39 |
Where Massachusetts sits
The same service costs 3.8 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· 39th of 51
$2.95
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.