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 $5.37 Median $5.37 Typical High $5.37 | Facility | None | $5.37 | $5.37 | $5.37 |
Aetna Setting Professional Modifier None Typical Low $5.37 Median $5.37 Typical High $8.32 | Professional | None | $5.37 | $5.37 | $8.32 |
AllWays Health Partners Setting Professional Modifier None Typical Low $4.57 Median $7.08 Typical High $147.91 | Professional | None | $4.57 | $7.08 | $147.91 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | None | $12.02 | $12.02 | $12.02 |
Cigna Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $6.46 | Professional | None | $4.90 | $4.90 | $6.46 |
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 $4.57 Median $10.23 Typical High $11.48 | Professional | None | $4.57 | $10.23 | $11.48 |
Mass General Brigham Setting Professional Modifier None Typical Low $4.57 Median $7.08 Typical High $147.91 | Professional | None | $4.57 | $7.08 | $147.91 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.75 Typical High $11.48 | Professional | None | $3.89 | $5.75 | $11.48 |
Well Sense Setting Facility Modifier None Typical Low $7.41 Median $10.23 Typical High $15.14 | Facility | None | $7.41 | $10.23 | $15.14 |
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 $2.69 Median $2.69 Typical High $4.17 | Professional | 52 · Reduced service | $2.69 | $2.69 | $4.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.07 Typical High $1.66 | Professional | 53 · Discontinued | $1.07 | $1.07 | $1.66 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $4.07 Median $4.07 Typical High $6.31 | Professional | 54 · Surgery only | $4.07 | $4.07 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.81 Median $0.81 Typical High $1.26 | Professional | 55 · Aftercare only | $0.81 | $0.81 | $1.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.54 Median $0.54 Typical High $0.83 | Professional | 56 · Pre-op care only | $0.54 | $0.54 | $0.83 |
Where Massachusetts sits
The same service costs 2.9 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· 39th of 51
$6.46
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.