How much rates vary
Facilitymedian $20 · 10th to 90th $6 to $6,918Professionalmedian $4 · 10th to 90th $3 to $6
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 $3.98 Median $3.98 Typical High $3.98 | Facility | None | $3.98 | $3.98 | $3.98 |
Aetna Setting Professional Modifier None Typical Low $3.98 Median $3.98 Typical High $4.07 | Professional | None | $3.98 | $3.98 | $4.07 |
AllWays Health Partners Setting Facility Modifier None Typical Low $6.17 Median $18.62 Typical High $20.42 | Facility | None | $6.17 | $18.62 | $20.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.46 | Professional | None | $6.17 | $6.17 | $6.46 |
Cigna Setting Professional Modifier None Typical Low $2.95 Median $2.95 Typical High $4.17 | Professional | None | $2.95 | $2.95 | $4.17 |
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 $2.69 Median $2.69 Typical High $2.69 | Professional | None | $2.69 | $2.69 | $2.69 |
Mass General Brigham Setting Facility Modifier None Typical Low $6.17 Median $18.62 Typical High $20.42 | Facility | None | $6.17 | $18.62 | $20.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $6.17 Median $6.17 Typical High $6.46 | Professional | None | $6.17 | $6.17 | $6.46 |
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 $3.39 Median $3.39 Typical High $3.39 | 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 | $3.39 | $3.39 | $3.39 |
Well Sense Setting Professional Modifier GV · Non-hospice attending Typical Low $2.40 Median $2.40 Typical High $2.88 | Professional | GV · Non-hospice attending | $2.40 | $2.40 | $2.88 |
Where Massachusetts sits
The same service costs 95.5 times more in Montana than in Georgia. 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· 23rd of 51
$3.98
MT $79.43GA $0.83
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.