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 $11.48 Median $11.48 Typical High $11.48 | Facility | None | $11.48 | $11.48 | $11.48 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.48 Typical High $15.14 | Professional | None | $11.48 | $11.48 | $15.14 |
AllWays Health Partners Setting Professional Modifier None Typical Low $9.77 Median $15.14 Typical High $213.80 | Professional | None | $9.77 | $15.14 | $213.80 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $10.47 Typical High $13.80 | Professional | None | $10.47 | $10.47 | $13.80 |
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 $9.77 Median $21.88 Typical High $24.55 | Professional | None | $9.77 | $21.88 | $24.55 |
Mass General Brigham Setting Professional Modifier None Typical Low $9.77 Median $15.14 Typical High $213.80 | Professional | None | $9.77 | $15.14 | $213.80 |
United Setting Professional Modifier None Typical Low $8.32 Median $12.59 Typical High $24.55 | Professional | None | $8.32 | $12.59 | $24.55 |
Well Sense Setting Facility Modifier None Typical Low $15.85 Median $21.88 Typical High $33.11 | Facility | None | $15.85 | $21.88 | $33.11 |
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 $5.75 Median $5.75 Typical High $7.59 | Professional | 52 · Reduced service | $5.75 | $5.75 | $7.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.29 Median $2.29 Typical High $3.02 | Professional | 53 · Discontinued | $2.29 | $2.29 | $3.02 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $8.71 Median $8.71 Typical High $11.22 | Professional | 54 · Surgery only | $8.71 | $8.71 | $11.22 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.74 Median $1.74 Typical High $2.24 | Professional | 55 · Aftercare only | $1.74 | $1.74 | $2.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.15 Median $1.15 Typical High $1.51 | Professional | 56 · Pre-op care only | $1.15 | $1.15 | $1.51 |
Where Massachusetts sits
The same service costs 2.8 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· 36th of 51
$12.88
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.