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 $4.47 Median $6.46 Typical High $19.95 | Facility | None | $4.47 | $6.46 | $19.95 |
Aetna Setting Professional Modifier None Typical Low $4.47 Median $4.47 Typical High $8.13 | Professional | None | $4.47 | $4.47 | $8.13 |
AllWays Health Partners Setting Facility Modifier None Typical Low $3.55 Median $5.25 Typical High $15.14 | Facility | None | $3.55 | $5.25 | $15.14 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.09 Median $4.79 Typical High $12.02 | Professional | None | $2.09 | $4.79 | $12.02 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $6.76 Median $11.48 Typical High $20.42 | Facility | None | $6.76 | $11.48 | $20.42 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $4.68 Median $6.03 Typical High $6.03 | Professional | None | $4.68 | $6.03 | $6.03 |
Cigna Setting Facility Modifier None Typical Low $3.09 Median $6.76 Typical High $12.30 | Facility | None | $3.09 | $6.76 | $12.30 |
Cigna Setting Professional Modifier None Typical Low $3.31 Median $5.75 Typical High $17.78 | Professional | None | $3.31 | $5.75 | $17.78 |
Fallon Health Setting Facility Modifier None Typical Low $6.76 Median $7.94 Typical High $4,897.79 | Facility | None | $6.76 | $7.94 | $4,897.79 |
Fallon Health Setting Professional Modifier None Typical Low $6.76 Median $6.76 Typical High $7.94 | Professional | None | $6.76 | $6.76 | $7.94 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.09 Median $4.79 Typical High $18.20 | Professional | None | $2.09 | $4.79 | $18.20 |
Health New England Setting Facility Modifier None Typical Low $5.75 Median $6.46 Typical High $41.69 | Facility | None | $5.75 | $6.46 | $41.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $3.55 Median $5.25 Typical High $15.14 | Facility | None | $3.55 | $5.25 | $15.14 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.09 Median $4.79 Typical High $12.02 | Professional | None | $2.09 | $4.79 | $12.02 |
Tufts Setting Facility Modifier None Typical Low $4.17 Median $5.37 Typical High $10.47 | Facility | None | $4.17 | $5.37 | $10.47 |
Tufts Setting Professional Modifier None Typical Low $4.17 Median $4.90 Typical High $7.59 | Professional | None | $4.17 | $4.90 | $7.59 |
United Setting Facility Modifier None Typical Low $1.38 Median $4.79 Typical High $10.47 | Facility | None | $1.38 | $4.79 | $10.47 |
United Setting Professional Modifier None Typical Low $1.91 Median $2.82 Typical High $10.00 | Professional | None | $1.91 | $2.82 | $10.00 |
Well Sense Setting Facility Modifier None Typical Low $4.17 Median $5.25 Typical High $8.32 | Facility | None | $4.17 | $5.25 | $8.32 |
Well Sense Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $5.89 | Professional | None | $4.90 | $4.90 | $5.89 |
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 $2.24 Median $2.24 Typical High $2.69 | Professional | 52 · Reduced service | $2.24 | $2.24 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.89 Median $0.89 Typical High $1.07 | Professional | 53 · Discontinued | $0.89 | $0.89 | $1.07 |
Fallon Health Setting Facility Modifier QW · Waived lab test Typical Low $4.79 Median $6.17 Typical High $7.41 | Facility | QW · Waived lab test | $4.79 | $6.17 | $7.41 |
Where Massachusetts sits
The same service costs 11.7 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
$5.62
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.