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 $10.96 Median $10.96 Typical High $10.96 | Facility | None | $10.96 | $10.96 | $10.96 |
Aetna Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $16.98 | Professional | None | $10.96 | $10.96 | $16.98 |
AllWays Health Partners Setting Professional Modifier None Typical Low $9.12 Median $14.45 Typical High $331.13 | Professional | None | $9.12 | $14.45 | $331.13 |
Cigna Setting Professional Modifier None Typical Low $9.77 Median $9.77 Typical High $13.18 | Professional | None | $9.77 | $9.77 | $13.18 |
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 $9.12 Median $20.89 Typical High $22.91 | Professional | None | $9.12 | $20.89 | $22.91 |
Mass General Brigham Setting Professional Modifier None Typical Low $9.12 Median $14.45 Typical High $331.13 | Professional | None | $9.12 | $14.45 | $331.13 |
United Setting Professional Modifier None Typical Low $7.94 Median $11.75 Typical High $22.91 | Professional | None | $7.94 | $11.75 | $22.91 |
Well Sense Setting Facility Modifier None Typical Low $15.14 Median $20.89 Typical High $30.90 | Facility | None | $15.14 | $20.89 | $30.90 |
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 $5.50 Median $5.50 Typical High $8.51 | Professional | 52 · Reduced service | $5.50 | $5.50 | $8.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.19 Median $2.19 Typical High $3.39 | Professional | 53 · Discontinued | $2.19 | $2.19 | $3.39 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.13 Median $8.13 Typical High $12.88 | Professional | 54 · Surgery only | $8.13 | $8.13 | $12.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.62 Median $1.62 Typical High $2.51 | Professional | 55 · Aftercare only | $1.62 | $1.62 | $2.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.10 Median $1.10 Typical High $1.70 | Professional | 56 · Pre-op care only | $1.10 | $1.10 | $1.70 |
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
$12.59
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.