How much rates vary
Facilitymedian $35 · 10th to 90th $26 to $87Professionalmedian $8 · 10th to 90th $4 to $74
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $6.03 | Professional | None | $5.89 | $5.89 | $6.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.89 Median $0.89 Typical High $0.93 | Professional | 55 · Aftercare only | $0.89 | $0.89 | $0.93 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.60 Median $0.60 Typical High $0.62 | Professional | 56 · Pre-op care only | $0.60 | $0.60 | $0.62 |
AllWays Health Partners Setting Facility Modifier None Typical Low $32.36 Median $34.67 Typical High $87.10 | Facility | None | $32.36 | $34.67 | $87.10 |
AllWays Health Partners Setting Professional Modifier None Typical Low $5.25 Median $26.30 Typical High $74.13 | Professional | None | $5.25 | $26.30 | $74.13 |
Cigna Setting Professional Modifier None Typical Low $7.41 Median $7.41 Typical High $10.23 | Professional | None | $7.41 | $7.41 | $10.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $4.17 Median $6.76 Typical High $13.18 | Professional | None | $4.17 | $6.76 | $13.18 |
Mass General Brigham Setting Facility Modifier None Typical Low $32.36 Median $34.67 Typical High $87.10 | Facility | None | $32.36 | $34.67 | $87.10 |
Mass General Brigham Setting Professional Modifier None Typical Low $5.25 Median $26.30 Typical High $74.13 | Professional | None | $5.25 | $26.30 | $74.13 |
United Setting Professional Modifier None Typical Low $4.17 Median $6.76 Typical High $13.18 | Professional | None | $4.17 | $6.76 | $13.18 |
2 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 |
|---|---|---|---|---|---|
Well Sense Setting Facility Modifier AU · Urologic/ostomy supply + AV · With prosthetic/orthotic + AW · With surgical dressing + AX · With dialysis + BA · With IV/tube nutrition + CB · Dialysis benefit, billed separately + CC · Code corrected + EM · Emergency reserve supply + EY · No order on file + G6 · Under 6 dialysis sessions + GA · Liability notice issued + GB · Resubmitted, left demonstration + GC · Resident with teaching physician + GE · Resident, primary care exception + GJ · Opt-out physician, urgent + GK · Related to waived item + GL · Free upgrade + GV · Non-hospice attending + GW · Unrelated to hospice condition + GZ · Expected denial + KB · Requested upgrade, 4+ modifiers + KX · Policy requirements met + Q2 · Demonstration procedure + Q6 · Substitute physician, paid per time + QV + SC · Medically necessary + SE · Publicly funded program + SQ · Ordered by home health + ST · Trauma related + TN · Rural / outside usual area + UK · On patient's behalf Typical Low $12.02 Median $12.02 Typical High $12.02 | Facility | AU · Urologic/ostomy supply + AV · With prosthetic/orthotic + AW · With surgical dressing + AX · With dialysis + BA · With IV/tube nutrition + CB · Dialysis benefit, billed separately + CC · Code corrected + EM · Emergency reserve supply + EY · No order on file + G6 · Under 6 dialysis sessions + GA · Liability notice issued + GB · Resubmitted, left demonstration + GC · Resident with teaching physician + GE · Resident, primary care exception + GJ · Opt-out physician, urgent + GK · Related to waived item + GL · Free upgrade + GV · Non-hospice attending + GW · Unrelated to hospice condition + GZ · Expected denial + KB · Requested upgrade, 4+ modifiers + KX · Policy requirements met + Q2 · Demonstration procedure + Q6 · Substitute physician, paid per time + QV + SC · Medically necessary + SE · Publicly funded program + SQ · Ordered by home health + ST · Trauma related + TN · Rural / outside usual area + UK · On patient's behalf | $12.02 | $12.02 | $12.02 |
Well Sense Setting Professional Modifier GV · Non-hospice attending Typical Low $8.51 Median $8.51 Typical High $10.23 | Professional | GV · Non-hospice attending | $8.51 | $8.51 | $10.23 |
Where Massachusetts sits
The same service costs 3.2 times more in Minnesota 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
$8.32
MN $16.98RI $5.25
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.