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 $2.63 Median $2.63 Typical High $2.63 | Facility | None | $2.63 | $2.63 | $2.63 |
Aetna Setting Professional Modifier None Typical Low $2.63 Median $2.63 Typical High $4.17 | Professional | None | $2.63 | $2.63 | $4.17 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.24 Median $3.47 Typical High $74.13 | Professional | None | $2.24 | $3.47 | $74.13 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $2.34 Median $2.34 Typical High $3.16 | Professional | None | $2.34 | $2.34 | $3.16 |
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 $2.24 Median $5.01 Typical High $5.62 | Professional | None | $2.24 | $5.01 | $5.62 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.24 Median $3.47 Typical High $74.13 | Professional | None | $2.24 | $3.47 | $74.13 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.82 Typical High $5.62 | Professional | None | $1.91 | $2.82 | $5.62 |
Well Sense Setting Facility Modifier None Typical Low $3.63 Median $5.01 Typical High $7.41 | Facility | None | $3.63 | $5.01 | $7.41 |
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 $1.32 Median $1.32 Typical High $2.04 | Professional | 52 · Reduced service | $1.32 | $1.32 | $2.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.52 Median $0.52 Typical High $0.81 | Professional | 53 · Discontinued | $0.52 | $0.52 | $0.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1.95 Median $1.95 Typical High $3.09 | Professional | 54 · Surgery only | $1.95 | $1.95 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.39 Median $0.39 Typical High $0.62 | Professional | 55 · Aftercare only | $0.39 | $0.39 | $0.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.26 Median $0.26 Typical High $0.41 | Professional | 56 · Pre-op care only | $0.26 | $0.26 | $0.41 |
Where Massachusetts sits
The same service costs 3.0 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
$3.02
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.