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 $23.44 Median $23.44 Typical High $23.44 | Facility | None | $23.44 | $23.44 | $23.44 |
Aetna Setting Professional Modifier None Typical Low $23.44 Median $23.44 Typical High $39.81 | Professional | None | $23.44 | $23.44 | $39.81 |
AllWays Health Partners Setting Professional Modifier None Typical Low $19.95 Median $31.62 Typical High $794.33 | Professional | None | $19.95 | $31.62 | $794.33 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $57.54 Median $67.61 Typical High $89.13 | Facility | None | $57.54 | $67.61 | $89.13 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $52.48 Median $52.48 Typical High $52.48 | Professional | None | $52.48 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $21.38 Median $21.38 Typical High $28.18 | Professional | None | $21.38 | $21.38 | $28.18 |
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 $19.95 Median $44.67 Typical High $50.12 | Professional | None | $19.95 | $44.67 | $50.12 |
Health New England Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Facility | None | $32.36 | $32.36 | $32.36 |
Health New England Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
Mass General Brigham Setting Professional Modifier None Typical Low $19.95 Median $31.62 Typical High $794.33 | Professional | None | $19.95 | $31.62 | $794.33 |
United Setting Professional Modifier None Typical Low $16.98 Median $25.70 Typical High $50.12 | Professional | None | $16.98 | $25.70 | $50.12 |
Well Sense Setting Facility Modifier None Typical Low $33.88 Median $46.77 Typical High $69.18 | Facility | None | $33.88 | $46.77 | $69.18 |
Well Sense Setting Professional Modifier None Typical Low $38.90 Median $38.90 Typical High $46.77 | Professional | None | $38.90 | $38.90 | $46.77 |
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 $11.75 Median $11.75 Typical High $18.62 | Professional | 52 · Reduced service | $11.75 | $11.75 | $18.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.79 Median $4.79 Typical High $7.41 | Professional | 53 · Discontinued | $4.79 | $4.79 | $7.41 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $17.78 Median $17.78 Typical High $27.54 | Professional | 54 · Surgery only | $17.78 | $17.78 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.55 Median $3.55 Typical High $5.62 | Professional | 55 · Aftercare only | $3.55 | $3.55 | $5.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.34 Median $2.34 Typical High $3.72 | Professional | 56 · Pre-op care only | $2.34 | $2.34 | $3.72 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii 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· 44th of 51
$28.18
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.