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 $19.50 Median $19.50 Typical High $19.50 | Facility | None | $19.50 | $19.50 | $19.50 |
Aetna Setting Professional Modifier None Typical Low $19.50 Median $19.50 Typical High $30.20 | Professional | None | $19.50 | $19.50 | $30.20 |
AllWays Health Partners Setting Professional Modifier None Typical Low $16.60 Median $26.30 Typical High $457.09 | Professional | None | $16.60 | $26.30 | $457.09 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $43.65 | Professional | None | $43.65 | $43.65 | $43.65 |
Cigna Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $23.44 | Professional | None | $17.78 | $17.78 | $23.44 |
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 $16.60 Median $37.15 Typical High $41.69 | Professional | None | $16.60 | $37.15 | $41.69 |
Mass General Brigham Setting Professional Modifier None Typical Low $16.60 Median $26.30 Typical High $457.09 | Professional | None | $16.60 | $26.30 | $457.09 |
United Setting Professional Modifier None Typical Low $14.13 Median $21.38 Typical High $41.69 | Professional | None | $14.13 | $21.38 | $41.69 |
Well Sense Setting Facility Modifier None Typical Low $26.92 Median $38.02 Typical High $56.23 | Facility | None | $26.92 | $38.02 | $56.23 |
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 $9.77 Median $9.77 Typical High $14.79 | Professional | 52 · Reduced service | $9.77 | $9.77 | $14.79 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.89 Median $3.89 Typical High $5.89 | Professional | 53 · Discontinued | $3.89 | $3.89 | $5.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $14.79 Median $14.79 Typical High $22.39 | Professional | 54 · Surgery only | $14.79 | $14.79 | $22.39 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.95 Median $2.95 Typical High $4.47 | Professional | 55 · Aftercare only | $2.95 | $2.95 | $4.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.95 Median $1.95 Typical High $2.95 | Professional | 56 · Pre-op care only | $1.95 | $1.95 | $2.95 |
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· 38th of 51
$23.44
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.