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 $16.22 Median $16.22 Typical High $19.95 | Facility | None | $16.22 | $16.22 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $18.62 | Professional | None | $16.22 | $16.22 | $18.62 |
AllWays Health Partners Setting Facility Modifier None Typical Low $17.78 Median $39.81 Typical High $52.48 | Facility | None | $17.78 | $39.81 | $52.48 |
AllWays Health Partners Setting Professional Modifier None Typical Low $13.80 Median $16.22 Typical High $72.44 | Professional | None | $13.80 | $16.22 | $72.44 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $16.22 Median $18.62 Typical High $33.11 | Facility | None | $16.22 | $18.62 | $33.11 |
Cigna Setting Facility Modifier None Typical Low $13.18 Median $28.84 Typical High $70.79 | Facility | None | $13.18 | $28.84 | $70.79 |
Cigna Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $28.18 | Professional | None | $16.22 | $16.22 | $28.18 |
Fallon Health Setting Facility Modifier None Typical Low $16.60 Median $20.42 Typical High $23.44 | Facility | None | $16.60 | $20.42 | $23.44 |
Fallon Health Setting Professional Modifier None Typical Low $19.05 Median $19.05 Typical High $22.39 | Professional | None | $19.05 | $19.05 | $22.39 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $13.80 Median $16.22 Typical High $50.12 | Professional | None | $13.80 | $16.22 | $50.12 |
Mass General Brigham Setting Facility Modifier None Typical Low $17.78 Median $39.81 Typical High $52.48 | Facility | None | $17.78 | $39.81 | $52.48 |
Mass General Brigham Setting Professional Modifier None Typical Low $13.80 Median $16.22 Typical High $72.44 | Professional | None | $13.80 | $16.22 | $72.44 |
Tufts Setting Facility Modifier None Typical Low $22.39 Median $22.39 Typical High $63.10 | Facility | None | $22.39 | $22.39 | $63.10 |
United Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Facility | None | $16.22 | $16.22 | $16.22 |
United Setting Professional Modifier None Typical Low $13.80 Median $14.45 Typical High $72.44 | Professional | None | $13.80 | $14.45 | $72.44 |
Well Sense Setting Facility Modifier None Typical Low $15.14 Median $23.44 Typical High $38.02 | Facility | None | $15.14 | $23.44 | $38.02 |
Well Sense Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $19.50 | Professional | None | $16.22 | $16.22 | $19.50 |
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 $8.13 Median $8.13 Typical High $8.13 | Professional | 52 · Reduced service | $8.13 | $8.13 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.24 Median $3.24 Typical High $3.24 | Professional | 53 · Discontinued | $3.24 | $3.24 | $3.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $2.40 Typical High $2.40 | Professional | 55 · Aftercare only | $2.40 | $2.40 | $2.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.62 |
Where Massachusetts sits
The same service costs 5.9 times more in Wyoming than in North Dakota. 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· 14th of 51
$17.78
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.