How much rates vary
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 $0.15 Median $0.15 Typical High $0.15 | Facility | None | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier None Typical Low $0.15 Median $0.15 Typical High $0.15 | Professional | None | $0.15 | $0.15 | $0.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
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 None Typical Low $6.03 Median $17.78 Typical High $19.95 | Facility | None | $6.03 | $17.78 | $19.95 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.17 Median $0.43 Typical High $6.03 | Professional | None | $0.17 | $0.43 | $6.03 |
Cigna Setting Professional Modifier None Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | None | $0.02 | $0.02 | $0.02 |
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 $0.16 Median $0.26 Typical High $0.40 | Professional | None | $0.16 | $0.26 | $0.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $6.03 Median $17.78 Typical High $19.95 | Facility | None | $6.03 | $17.78 | $19.95 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.17 Median $0.43 Typical High $6.03 | Professional | None | $0.17 | $0.43 | $6.03 |
United Setting Professional Modifier None Typical Low $0.16 Median $0.26 Typical High $0.40 | Professional | None | $0.16 | $0.26 | $0.40 |
Well Sense Setting Facility Modifier None Typical Low $0.44 Median $0.44 Typical High $0.44 | Facility | None | $0.44 | $0.44 | $0.44 |
1 more rate 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 Professional Modifier GV · Non-hospice attending Typical Low $3.80 Median $3.80 Typical High $4.57 | Professional | GV · Non-hospice attending | $3.80 | $3.80 | $4.57 |
Where Massachusetts sits
The same service costs 24.5 times more in North Carolina than in Oregon. 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· 9th of 51
$0.26
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.