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 $0.46 Median $0.46 Typical High $0.46 | Facility | None | $0.46 | $0.46 | $0.46 |
Aetna Setting Professional Modifier None Typical Low $0.46 Median $0.46 Typical High $0.46 | Professional | None | $0.46 | $0.46 | $0.46 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.40 Median $1.12 Typical High $2.45 | Facility | None | $0.40 | $1.12 | $2.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.40 Median $0.78 Typical High $5.75 | Professional | None | $0.40 | $0.78 | $5.75 |
Cigna Setting Professional Modifier None Typical Low $1.12 Median $1.12 Typical High $1.12 | Professional | None | $1.12 | $1.12 | $1.12 |
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 $0.34 Median $0.52 Typical High $0.81 | Professional | None | $0.34 | $0.52 | $0.81 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.40 Median $1.12 Typical High $2.45 | Facility | None | $0.40 | $1.12 | $2.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.40 Median $0.78 Typical High $5.75 | Professional | None | $0.40 | $0.78 | $5.75 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.52 Typical High $0.81 | Professional | None | $0.34 | $0.52 | $0.81 |
Well Sense Setting Facility Modifier None Typical Low $0.36 Median $0.63 Typical High $0.93 | Facility | None | $0.36 | $0.63 | $0.93 |
Well Sense Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.49 | Professional | None | $0.36 | $0.36 | $0.49 |
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 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Well Sense Setting Professional Modifier GV · Non-hospice attending Typical Low $0.40 Median $0.40 Typical High $0.54 | Professional | GV · Non-hospice attending | $0.40 | $0.40 | $0.54 |
Where Massachusetts sits
The same service costs 2.9 times more in Minnesota than in Ohio. 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· 34th of 51
$0.52
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.