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 $0.27 Median $0.27 Typical High $1.26 | Facility | None | $0.27 | $0.27 | $1.26 |
Aetna Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.52 | Professional | None | $0.27 | $0.27 | $0.52 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.59 Median $0.62 Typical High $2.00 | Facility | None | $0.59 | $0.62 | $2.00 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.28 Median $0.63 Typical High $4.37 | Professional | None | $0.28 | $0.63 | $4.37 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
Cigna Setting Professional Modifier None Typical Low $0.31 Median $0.31 Typical High $0.43 | Professional | None | $0.31 | $0.31 | $0.43 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.24 Median $0.54 Typical High $0.62 | Professional | None | $0.24 | $0.54 | $0.62 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.59 Median $0.62 Typical High $2.00 | Facility | None | $0.59 | $0.62 | $2.00 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.28 Median $0.63 Typical High $4.37 | Professional | None | $0.28 | $0.63 | $4.37 |
Tufts Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.40 | Professional | None | $0.40 | $0.40 | $0.40 |
United Setting Professional Modifier None Typical Low $0.20 Median $0.31 Typical High $0.62 | Professional | None | $0.20 | $0.31 | $0.62 |
Well Sense Setting Facility Modifier None Typical Low $0.52 Median $0.72 Typical High $1.07 | Facility | None | $0.52 | $0.72 | $1.07 |
Well Sense Setting Professional Modifier None Typical Low $0.40 Median $1.00 Typical High $3.16 | Professional | None | $0.40 | $1.00 | $3.16 |
5 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 $0.14 Median $0.14 Typical High $0.62 | Professional | 52 · Reduced service | $0.14 | $0.14 | $0.62 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.05 Typical High $0.25 | Professional | 53 · Discontinued | $0.05 | $0.05 | $0.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.19 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.12 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.12 |
Aetna Setting Professional Modifier RR · Rental Typical Low $0.17 Median $0.17 Typical High $0.17 | Professional | RR · Rental | $0.17 | $0.17 | $0.17 |
Where Massachusetts sits
The same service costs 4.6 times more in Hawaii than in Rhode Island. 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· 12th of 51
$0.54
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.