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 $0.79 Median $0.79 Typical High $0.79 | Facility | None | $0.79 | $0.79 | $0.79 |
Aetna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.17 Median $2.00 Typical High $2.63 | Facility | None | $1.17 | $2.00 | $2.63 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.79 Median $0.83 Typical High $4.90 | Professional | None | $0.79 | $0.83 | $4.90 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.79 Median $0.91 Typical High $1.66 | Facility | None | $0.79 | $0.91 | $1.66 |
Cigna Setting Facility Modifier None Typical Low $1.02 Median $1.70 Typical High $3.47 | Facility | None | $1.02 | $1.70 | $3.47 |
Cigna Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.79 | Professional | None | $0.79 | $0.79 | $0.79 |
Fallon Health Setting Facility Modifier None Typical Low $0.79 Median $1.05 Typical High $1.15 | Facility | None | $0.79 | $1.05 | $1.15 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $0.83 | Professional | None | $0.79 | $0.79 | $0.83 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.17 Median $2.00 Typical High $2.63 | Facility | None | $1.17 | $2.00 | $2.63 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.79 Median $0.83 Typical High $4.90 | Professional | None | $0.79 | $0.83 | $4.90 |
United Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.00 | Professional | None | $0.79 | $0.79 | $1.00 |
Well Sense Setting Facility Modifier None Typical Low $0.87 Median $1.10 Typical High $1.86 | Facility | None | $0.87 | $1.10 | $1.86 |
Well Sense Setting Professional Modifier None Typical Low $0.79 Median $0.79 Typical High $1.07 | Professional | None | $0.79 | $0.79 | $1.07 |
4 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 $0.40 Median $0.40 Typical High $0.40 | Professional | 52 · Reduced service | $0.40 | $0.40 | $0.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.16 Median $0.16 Typical High $0.16 | Professional | 53 · Discontinued | $0.16 | $0.16 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.12 Median $0.12 Typical High $0.12 | Professional | 55 · Aftercare only | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Where Massachusetts sits
Rates are fairly even across states for this service. 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
$0.79
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.