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 Professional Modifier None Typical Low $389.05 Median $416.87 Typical High $416.87 | Professional | None | $389.05 | $416.87 | $416.87 |
AllWays Health Partners Setting Facility Modifier None Typical Low $575.44 Median $1,412.54 Typical High $1,778.28 | Facility | None | $575.44 | $1,412.54 | $1,778.28 |
AllWays Health Partners Setting Professional Modifier None Typical Low $309.03 Median $1,000.00 Typical High $2,570.40 | Professional | None | $309.03 | $1,000.00 | $2,570.40 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $831.76 Median $1,174.90 Typical High $1,659.59 | Facility | None | $831.76 | $1,174.90 | $1,659.59 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $478.63 Median $478.63 Typical High $512.86 | Professional | None | $478.63 | $478.63 | $512.86 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $407.38 Typical High $1,096.48 | Facility | None | $354.81 | $407.38 | $1,096.48 |
Cigna Setting Professional Modifier None Typical Low $309.03 Median $549.54 Typical High $2,041.74 | Professional | None | $309.03 | $549.54 | $2,041.74 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $870.96 Typical High $5,888.44 | Facility | None | $83.18 | $870.96 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $741.31 Median $741.31 Typical High $870.96 | Professional | None | $741.31 | $741.31 | $870.96 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $309.03 Median $524.81 Typical High $1,174.90 | Professional | None | $309.03 | $524.81 | $1,174.90 |
Mass General Brigham Setting Facility Modifier None Typical Low $575.44 Median $1,412.54 Typical High $1,778.28 | Facility | None | $575.44 | $1,412.54 | $1,778.28 |
Mass General Brigham Setting Professional Modifier None Typical Low $309.03 Median $1,000.00 Typical High $2,570.40 | Professional | None | $309.03 | $1,000.00 | $2,570.40 |
United Setting Facility Modifier None Typical Low $467.74 Median $524.81 Typical High $630.96 | Facility | None | $467.74 | $524.81 | $630.96 |
United Setting Professional Modifier None Typical Low $208.93 Median $309.03 Typical High $1,000.00 | Professional | None | $208.93 | $309.03 | $1,000.00 |
Well Sense Setting Facility Modifier None Typical Low $457.09 Median $630.96 Typical High $933.25 | Facility | None | $457.09 | $630.96 | $933.25 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 Facility Modifier 53 · Discontinued Typical Low $72.44 Median $144.54 Typical High $323.59 | Facility | 53 · Discontinued | $72.44 | $144.54 | $323.59 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $181.97 Median $181.97 Typical High $181.97 | Professional | 52 · Reduced service | $181.97 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | 53 · Discontinued | $72.44 | $72.44 | $72.44 |
Fallon Health Setting Facility Modifier QW · Waived lab test Typical Low $524.81 Median $676.08 Typical High $812.83 | Facility | QW · Waived lab test | $524.81 | $676.08 | $812.83 |
Where Massachusetts sits
The same service costs 8.1 times more in Texas than in Georgia. 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· 9th of 51
$631
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.