How much rates vary
Facilitymedian $1 · 10th to 90th $1 to $2,951Professionalmedian $0 · 10th to 90th $0 to $40
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 $0.22 Median $0.22 Typical High $0.22 | Facility | None | $0.22 | $0.22 | $0.22 |
Aetna Setting Professional Modifier None Typical Low $0.22 Median $0.22 Typical High $0.24 | Professional | None | $0.22 | $0.22 | $0.24 |
Aetna Setting Professional Modifier AW · With surgical dressing Typical Low $0.24 Median $0.24 Typical High $1.12 | Professional | AW · With surgical dressing | $0.24 | $0.24 | $1.12 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.51 Median $0.51 Typical High $1.58 | Facility | None | $0.51 | $0.51 | $1.58 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.21 Median $0.50 Typical High $39.81 | Professional | None | $0.21 | $0.50 | $39.81 |
AllWays Health Partners Setting Professional Modifier AW · With surgical dressing Typical Low $0.45 Median $0.54 Typical High $0.56 | Professional | AW · With surgical dressing | $0.45 | $0.54 | $0.56 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $0.33 | Professional | None | $0.32 | $0.32 | $0.33 |
Cigna Setting Professional Modifier None Typical Low $0.26 Median $0.26 Typical High $0.36 | Professional | None | $0.26 | $0.26 | $0.36 |
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 $0.21 Median $0.46 Typical High $0.52 | Professional | None | $0.21 | $0.46 | $0.52 |
Health New England Setting Professional Modifier None Typical Low $17.38 Median $17.38 Typical High $17.38 | Professional | None | $17.38 | $17.38 | $17.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.51 Median $0.51 Typical High $1.58 | Facility | None | $0.51 | $0.51 | $1.58 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.21 Median $0.50 Typical High $39.81 | Professional | None | $0.21 | $0.50 | $39.81 |
Mass General Brigham Setting Professional Modifier AW · With surgical dressing Typical Low $0.45 Median $0.54 Typical High $0.56 | Professional | AW · With surgical dressing | $0.45 | $0.54 | $0.56 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.27 Typical High $0.52 | Professional | None | $0.18 | $0.27 | $0.52 |
Well Sense Setting Facility Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Facility | None | $0.35 | $0.35 | $0.35 |
Well Sense Setting Facility Modifier AW · With surgical dressing Typical Low $0.44 Median $0.62 Typical High $1.02 | Facility | AW · With surgical dressing | $0.44 | $0.62 | $1.02 |
Well Sense Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.35 | Professional | None | $0.28 | $0.28 | $0.35 |
10 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 55 · Aftercare only Typical Low $0.03 Median $0.03 Typical High $0.03 | Professional | 55 · Aftercare only | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
AllWays Health Partners Setting Facility Modifier AU · Urologic/ostomy supply Typical Low $0.47 Median $0.47 Typical High $0.76 | Facility | AU · Urologic/ostomy supply | $0.47 | $0.47 | $0.76 |
AllWays Health Partners Setting Facility Modifier AV · With prosthetic/orthotic Typical Low $0.47 Median $0.47 Typical High $0.76 | Facility | AV · With prosthetic/orthotic | $0.47 | $0.47 | $0.76 |
AllWays Health Partners Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.41 Median $0.50 Typical High $0.52 | Professional | AU · Urologic/ostomy supply | $0.41 | $0.50 | $0.52 |
AllWays Health Partners Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.41 Median $0.50 Typical High $0.52 | Professional | AV · With prosthetic/orthotic | $0.41 | $0.50 | $0.52 |
Mass General Brigham Setting Facility Modifier AU · Urologic/ostomy supply Typical Low $0.47 Median $0.47 Typical High $0.76 | Facility | AU · Urologic/ostomy supply | $0.47 | $0.47 | $0.76 |
Mass General Brigham Setting Facility Modifier AV · With prosthetic/orthotic Typical Low $0.47 Median $0.47 Typical High $0.76 | Facility | AV · With prosthetic/orthotic | $0.47 | $0.47 | $0.76 |
Mass General Brigham Setting Professional Modifier AU · Urologic/ostomy supply Typical Low $0.41 Median $0.50 Typical High $0.52 | Professional | AU · Urologic/ostomy supply | $0.41 | $0.50 | $0.52 |
Mass General Brigham Setting Professional Modifier AV · With prosthetic/orthotic Typical Low $0.41 Median $0.50 Typical High $0.52 | Professional | AV · With prosthetic/orthotic | $0.41 | $0.50 | $0.52 |
Where Massachusetts sits
The same service costs 2.5 times more in Montana than in Colorado. 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
$0.36
MT $0.56CO $0.23
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.