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 $13.49 Median $27.54 Typical High $64.57 | Facility | None | $13.49 | $27.54 | $64.57 |
Aetna Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $21.38 | Professional | None | $13.49 | $13.49 | $21.38 |
AllWays Health Partners Setting Facility Modifier None Typical Low $11.48 Median $16.98 Typical High $46.77 | Facility | None | $11.48 | $16.98 | $46.77 |
AllWays Health Partners Setting Professional Modifier None Typical Low $9.12 Median $15.49 Typical High $44.67 | Professional | None | $9.12 | $15.49 | $44.67 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $19.95 Median $37.15 Typical High $60.26 | Facility | None | $19.95 | $37.15 | $60.26 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $14.45 Median $15.14 Typical High $18.20 | Professional | None | $14.45 | $15.14 | $18.20 |
Cigna Setting Facility Modifier None Typical Low $10.00 Median $21.88 Typical High $39.81 | Facility | None | $10.00 | $21.88 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $10.47 Median $18.62 Typical High $60.26 | Professional | None | $10.47 | $18.62 | $60.26 |
Fallon Health Setting Facility Modifier None Typical Low $20.89 Median $25.70 Typical High $4,897.79 | Facility | None | $20.89 | $25.70 | $4,897.79 |
Fallon Health Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $25.70 | Professional | None | $21.88 | $21.88 | $25.70 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $7.59 Median $15.49 Typical High $58.88 | Professional | None | $7.59 | $15.49 | $58.88 |
Health New England Setting Facility Modifier None Typical Low $14.45 Median $18.62 Typical High $169.82 | Facility | None | $14.45 | $18.62 | $169.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $11.48 Median $16.98 Typical High $46.77 | Facility | None | $11.48 | $16.98 | $46.77 |
Mass General Brigham Setting Professional Modifier None Typical Low $9.12 Median $15.49 Typical High $44.67 | Professional | None | $9.12 | $15.49 | $44.67 |
United Setting Facility Modifier None Typical Low $13.80 Median $15.49 Typical High $18.20 | Facility | None | $13.80 | $15.49 | $18.20 |
United Setting Professional Modifier None Typical Low $6.17 Median $11.75 Typical High $46.77 | Professional | None | $6.17 | $11.75 | $46.77 |
Well Sense Setting Facility Modifier None Typical Low $13.49 Median $16.98 Typical High $26.92 | Facility | None | $13.49 | $16.98 | $26.92 |
Well Sense Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $17.78 | Professional | None | $14.79 | $14.79 | $17.78 |
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 $6.76 Median $6.76 Typical High $8.13 | Professional | 52 · Reduced service | $6.76 | $6.76 | $8.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.69 Median $2.69 Typical High $3.24 | Professional | 53 · Discontinued | $2.69 | $2.69 | $3.24 |
Fallon Health Setting Facility Modifier QW · Waived lab test Typical Low $15.49 Median $19.95 Typical High $23.99 | Facility | QW · Waived lab test | $15.49 | $19.95 | $23.99 |
Where Massachusetts sits
The same service costs 20.9 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· 15th of 51
$18.20
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.