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 $4.79 Median $9.55 Typical High $21.88 | Facility | None | $4.79 | $9.55 | $21.88 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.79 Typical High $8.71 | Professional | None | $4.47 | $4.79 | $8.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3.80 Median $5.50 Typical High $15.85 | Facility | None | $3.80 | $5.50 | $15.85 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.09 Median $5.01 Typical High $12.59 | Professional | None | $2.09 | $5.01 | $12.59 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $6.92 Median $12.30 Typical High $20.89 | Facility | None | $6.92 | $12.30 | $20.89 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $4.90 Median $6.31 Typical High $6.31 | Professional | None | $4.90 | $6.31 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $3.47 Median $7.24 Typical High $12.88 | Facility | None | $3.47 | $7.24 | $12.88 |
Cigna Setting Professional Modifier None Typical Low $3.47 Median $6.17 Typical High $19.05 | Professional | None | $3.47 | $6.17 | $19.05 |
Fallon Health Setting Facility Modifier None Typical Low $7.24 Median $8.51 Typical High $4,897.79 | Facility | None | $7.24 | $8.51 | $4,897.79 |
Fallon Health Setting Professional Modifier None Typical Low $7.24 Median $7.24 Typical High $8.51 | Professional | None | $7.24 | $7.24 | $8.51 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.09 Median $5.01 Typical High $19.50 | Professional | None | $2.09 | $5.01 | $19.50 |
Health New England Setting Facility Modifier None Typical Low $6.17 Median $6.92 Typical High $52.48 | Facility | None | $6.17 | $6.92 | $52.48 |
Mass General Brigham Setting Facility Modifier None Typical Low $3.80 Median $5.50 Typical High $15.85 | Facility | None | $3.80 | $5.50 | $15.85 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.09 Median $5.01 Typical High $12.59 | Professional | None | $2.09 | $5.01 | $12.59 |
Tufts Setting Facility Modifier None Typical Low $4.47 Median $5.75 Typical High $11.48 | Facility | None | $4.47 | $5.75 | $11.48 |
Tufts Setting Professional Modifier None Typical Low $4.47 Median $5.13 Typical High $7.94 | Professional | None | $4.47 | $5.13 | $7.94 |
United Setting Facility Modifier None Typical Low $1.58 Median $5.01 Typical High $5.01 | Facility | None | $1.58 | $5.01 | $5.01 |
United Setting Professional Modifier None Typical Low $2.00 Median $3.02 Typical High $10.47 | Professional | None | $2.00 | $3.02 | $10.47 |
Well Sense Setting Facility Modifier None Typical Low $4.47 Median $5.50 Typical High $8.71 | Facility | None | $4.47 | $5.50 | $8.71 |
Well Sense Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $6.31 | Professional | None | $5.25 | $5.25 | $6.31 |
3 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 $2.40 Median $2.40 Typical High $2.88 | Professional | 52 · Reduced service | $2.40 | $2.40 | $2.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.95 Median $0.95 Typical High $1.12 | Professional | 53 · Discontinued | $0.95 | $0.95 | $1.12 |
Fallon Health Setting Facility Modifier QW · Waived lab test Typical Low $5.01 Median $6.46 Typical High $7.76 | Facility | QW · Waived lab test | $5.01 | $6.46 | $7.76 |
Where Massachusetts sits
The same service costs 8.9 times more in Vermont than in Maryland. 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· 19th of 51
$5.89
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.