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 $18.62 Median $18.62 Typical High $29.51 | Facility | None | $18.62 | $18.62 | $29.51 |
Aetna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $19.05 | Professional | None | $18.62 | $18.62 | $19.05 |
AllWays Health Partners Setting Facility Modifier None Typical Low $20.42 Median $48.98 Typical High $60.26 | Facility | None | $20.42 | $48.98 | $60.26 |
AllWays Health Partners Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $22.91 | Professional | None | $18.62 | $20.42 | $22.91 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $18.62 Median $20.89 Typical High $38.02 | Facility | None | $18.62 | $20.89 | $38.02 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $18.62 Median $30.20 Typical High $34.67 | Professional | None | $18.62 | $30.20 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $20.89 Median $33.11 Typical High $81.28 | Facility | None | $20.89 | $33.11 | $81.28 |
Cigna Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Professional | None | $18.62 | $18.62 | $18.62 |
Fallon Health Setting Facility Modifier None Typical Low $22.39 Median $28.18 Typical High $35.48 | Facility | None | $22.39 | $28.18 | $35.48 |
Fallon Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $35.48 | Professional | None | $30.20 | $30.20 | $35.48 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $18.62 Median $19.50 Typical High $21.38 | Professional | None | $18.62 | $19.50 | $21.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $20.42 Median $48.98 Typical High $60.26 | Facility | None | $20.42 | $48.98 | $60.26 |
Mass General Brigham Setting Professional Modifier None Typical Low $18.62 Median $20.42 Typical High $22.91 | Professional | None | $18.62 | $20.42 | $22.91 |
United Setting Facility Modifier None Typical Low $18.62 Median $18.62 Typical High $18.62 | Facility | None | $18.62 | $18.62 | $18.62 |
United Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $22.91 | Professional | None | $20.42 | $20.42 | $22.91 |
Well Sense Setting Facility Modifier None Typical Low $22.39 Median $28.18 Typical High $42.66 | Facility | None | $22.39 | $28.18 | $42.66 |
Well Sense Setting Professional Modifier None Typical Low $18.62 Median $18.62 Typical High $25.12 | Professional | None | $18.62 | $18.62 | $25.12 |
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 $9.33 Median $9.33 Typical High $9.33 | Professional | 52 · Reduced service | $9.33 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $3.72 Typical High $3.72 | Professional | 53 · Discontinued | $3.72 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.75 Median $2.75 Typical High $2.75 | Professional | 55 · Aftercare only | $2.75 | $2.75 | $2.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $1.86 Typical High $1.86 | Professional | 56 · Pre-op care only | $1.86 | $1.86 | $1.86 |
Where Massachusetts sits
The same service costs 1.8 times more in Hawaii than in Ohio. 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· 24th of 51
$20.42
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.