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 $10.47 Median $18.20 Typical High $85.11 | Facility | None | $10.47 | $18.20 | $85.11 |
Aetna Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $21.38 | Professional | None | $18.20 | $18.20 | $21.38 |
AllWays Health Partners Setting Facility Modifier None Typical Low $15.85 Median $22.91 Typical High $64.57 | Facility | None | $15.85 | $22.91 | $64.57 |
AllWays Health Partners Setting Professional Modifier None Typical Low $12.59 Median $20.89 Typical High $53.70 | Professional | None | $12.59 | $20.89 | $53.70 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $26.92 Median $46.77 Typical High $81.28 | Facility | None | $26.92 | $46.77 | $81.28 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $19.95 Median $20.42 Typical High $23.99 | Professional | None | $19.95 | $20.42 | $23.99 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $28.84 Typical High $48.98 | Facility | None | $13.80 | $28.84 | $48.98 |
Cigna Setting Professional Modifier None Typical Low $12.88 Median $25.70 Typical High $81.28 | Professional | None | $12.88 | $25.70 | $81.28 |
Fallon Health Setting Facility Modifier None Typical Low $23.99 Median $35.48 Typical High $4,897.79 | Facility | None | $23.99 | $35.48 | $4,897.79 |
Fallon Health Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $35.48 | Professional | None | $30.20 | $30.20 | $35.48 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.47 Median $20.89 Typical High $74.13 | Professional | None | $10.47 | $20.89 | $74.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $15.85 Median $22.91 Typical High $64.57 | Facility | None | $15.85 | $22.91 | $64.57 |
Mass General Brigham Setting Professional Modifier None Typical Low $12.59 Median $20.89 Typical High $53.70 | Professional | None | $12.59 | $20.89 | $53.70 |
United Setting Facility Modifier None Typical Low $19.05 Median $20.89 Typical High $25.12 | Facility | None | $19.05 | $20.89 | $25.12 |
United Setting Professional Modifier None Typical Low $8.51 Median $15.85 Typical High $44.67 | Professional | None | $8.51 | $15.85 | $44.67 |
Well Sense Setting Facility Modifier None Typical Low $18.62 Median $23.44 Typical High $36.31 | Facility | None | $18.62 | $23.44 | $36.31 |
Well Sense Setting Professional Modifier None Typical Low $19.95 Median $19.95 Typical High $23.44 | Professional | None | $19.95 | $19.95 | $23.44 |
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 $9.12 Median $9.12 Typical High $10.72 | Professional | 52 · Reduced service | $9.12 | $9.12 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.63 Median $3.63 Typical High $4.37 | Professional | 53 · Discontinued | $3.63 | $3.63 | $4.37 |
Fallon Health Setting Facility Modifier QW · Waived lab test Typical Low $20.89 Median $27.54 Typical High $32.36 | Facility | QW · Waived lab test | $20.89 | $27.54 | $32.36 |
Where Massachusetts sits
The same service costs 3.4 times more in Kansas than in New Jersey. 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
$22.91
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.