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 $8.32 Median $23.44 Typical High $38.90 | Facility | None | $8.32 | $23.44 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $12.88 | Professional | None | $8.32 | $8.32 | $12.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $7.41 Median $10.72 Typical High $30.20 | Facility | None | $7.41 | $10.72 | $30.20 |
AllWays Health Partners Setting Professional Modifier None Typical Low $5.25 Median $9.77 Typical High $24.55 | Professional | None | $5.25 | $9.77 | $24.55 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $12.30 Median $21.38 Typical High $37.15 | Facility | None | $12.30 | $21.38 | $37.15 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $9.12 Median $9.55 Typical High $11.22 | Professional | None | $9.12 | $9.55 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $6.46 Median $13.18 Typical High $22.91 | Facility | None | $6.46 | $13.18 | $22.91 |
Cigna Setting Professional Modifier None Typical Low $6.31 Median $11.75 Typical High $38.02 | Professional | None | $6.31 | $11.75 | $38.02 |
Fallon Health Setting Facility Modifier None Typical Low $12.59 Median $16.22 Typical High $4,897.79 | Facility | None | $12.59 | $16.22 | $4,897.79 |
Fallon Health Setting Professional Modifier None Typical Low $13.80 Median $13.80 Typical High $16.22 | Professional | None | $13.80 | $13.80 | $16.22 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4.90 Median $9.77 Typical High $33.88 | Professional | None | $4.90 | $9.77 | $33.88 |
Health New England Setting Facility Modifier None Typical Low $12.02 Median $20.42 Typical High $218.78 | Facility | None | $12.02 | $20.42 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $7.41 Median $10.72 Typical High $30.20 | Facility | None | $7.41 | $10.72 | $30.20 |
Mass General Brigham Setting Professional Modifier None Typical Low $5.25 Median $9.77 Typical High $24.55 | Professional | None | $5.25 | $9.77 | $24.55 |
United Setting Facility Modifier None Typical Low $8.71 Median $9.77 Typical High $11.75 | Facility | None | $8.71 | $9.77 | $11.75 |
United Setting Professional Modifier None Typical Low $3.89 Median $5.89 Typical High $20.42 | Professional | None | $3.89 | $5.89 | $20.42 |
Well Sense Setting Facility Modifier None Typical Low $8.71 Median $10.72 Typical High $16.98 | Facility | None | $8.71 | $10.72 | $16.98 |
Well Sense Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $10.96 | Professional | None | $9.12 | $9.12 | $10.96 |
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 $4.17 Median $4.17 Typical High $5.01 | Professional | 52 · Reduced service | $4.17 | $4.17 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.66 Typical High $2.00 | Professional | 53 · Discontinued | $1.66 | $1.66 | $2.00 |
Fallon Health Setting Facility Modifier QW · Waived lab test Typical Low $9.77 Median $12.59 Typical High $15.14 | Facility | QW · Waived lab test | $9.77 | $12.59 | $15.14 |
Where Massachusetts sits
The same service costs 4.1 times more in Kansas than in Kentucky. 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· 20th of 51
$10.72
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.