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 $3.89 Median $3.89 Typical High $3.89 | Facility | None | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier None Typical Low $3.89 Median $3.89 Typical High $7.41 | Professional | None | $3.89 | $3.89 | $7.41 |
AllWays Health Partners Setting Professional Modifier None Typical Low $3.31 Median $5.37 Typical High $147.91 | Professional | None | $3.31 | $5.37 | $147.91 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $8.51 Median $8.51 Typical High $8.51 | Professional | None | $8.51 | $8.51 | $8.51 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $3.47 Typical High $4.68 | Professional | None | $3.47 | $3.47 | $4.68 |
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 $3.31 Median $7.41 Typical High $8.13 | Professional | None | $3.31 | $7.41 | $8.13 |
Mass General Brigham Setting Professional Modifier None Typical Low $3.31 Median $5.37 Typical High $147.91 | Professional | None | $3.31 | $5.37 | $147.91 |
United Setting Professional Modifier None Typical Low $2.82 Median $4.17 Typical High $8.13 | Professional | None | $2.82 | $4.17 | $8.13 |
Well Sense Setting Facility Modifier None Typical Low $5.50 Median $7.76 Typical High $11.48 | Facility | None | $5.50 | $7.76 | $11.48 |
Well Sense Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $13.49 | Professional | None | $11.22 | $11.22 | $13.49 |
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 $1.95 Median $1.95 Typical High $3.02 | Professional | 52 · Reduced service | $1.95 | $1.95 | $3.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.78 Median $0.78 Typical High $1.23 | Professional | 53 · Discontinued | $0.78 | $0.78 | $1.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2.88 Median $2.88 Typical High $4.57 | Professional | 54 · Surgery only | $2.88 | $2.88 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.58 Median $0.58 Typical High $0.91 | Professional | 55 · Aftercare only | $0.58 | $0.58 | $0.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.39 Median $0.39 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.39 | $0.39 | $0.62 |
Where Massachusetts sits
The same service costs 4.1 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· 41st of 51
$4.57
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.