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 $12.59 Median $12.59 Typical High $38.90 | Facility | None | $12.59 | $12.59 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $10.23 Median $12.59 Typical High $12.59 | Professional | None | $10.23 | $12.59 | $12.59 |
AllWays Health Partners Setting Facility Modifier None Typical Low $18.62 Median $19.95 Typical High $66.07 | Facility | None | $18.62 | $19.95 | $66.07 |
AllWays Health Partners Setting Professional Modifier None Typical Low $9.77 Median $16.22 Typical High $125.89 | Professional | None | $9.77 | $16.22 | $125.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $21.88 Median $25.70 Typical High $33.88 | Facility | None | $21.88 | $25.70 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $9.55 Median $9.55 Typical High $9.55 | Professional | None | $9.55 | $9.55 | $9.55 |
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 $9.77 Median $17.38 Typical High $17.38 | Professional | None | $9.77 | $17.38 | $17.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $18.62 Median $19.95 Typical High $66.07 | Facility | None | $18.62 | $19.95 | $66.07 |
Mass General Brigham Setting Professional Modifier None Typical Low $9.77 Median $16.22 Typical High $125.89 | Professional | None | $9.77 | $16.22 | $125.89 |
United Setting Facility Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | None | $26.92 | $26.92 | $26.92 |
United Setting Professional Modifier None Typical Low $7.76 Median $10.00 Typical High $13.18 | Professional | None | $7.76 | $10.00 | $13.18 |
Well Sense Setting Facility Modifier None Typical Low $13.80 Median $19.50 Typical High $28.84 | Facility | None | $13.80 | $19.50 | $28.84 |
Well Sense Setting Professional Modifier None Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | None | $26.92 | $26.92 | $26.92 |
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 $5.13 Median $6.31 Typical High $6.31 | Professional | 52 · Reduced service | $5.13 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.04 Median $2.51 Typical High $2.51 | Professional | 53 · Discontinued | $2.04 | $2.51 | $2.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $1.86 Typical High $1.86 | Professional | 55 · Aftercare only | $1.55 | $1.86 | $1.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.26 Typical High $1.26 | Professional | 56 · Pre-op care only | $1.05 | $1.26 | $1.26 |
Where Massachusetts sits
The same service costs 3.0 times more in Montana 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· 35th of 51
$12.59
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.