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 $0.41 Median $0.41 Typical High $1.86 | Facility | None | $0.41 | $0.41 | $1.86 |
Aetna Setting Professional Modifier None Typical Low $0.41 Median $0.41 Typical High $1.86 | Professional | None | $0.41 | $0.41 | $1.86 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.91 Median $0.95 Typical High $3.09 | Facility | None | $0.91 | $0.95 | $3.09 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.41 Median $0.98 Typical High $4.79 | Professional | None | $0.41 | $0.98 | $4.79 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $0.63 Median $0.63 Typical High $0.65 | Professional | None | $0.63 | $0.63 | $0.65 |
Cigna Setting Professional Modifier None Typical Low $0.49 Median $0.49 Typical High $0.68 | Professional | None | $0.49 | $0.49 | $0.68 |
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 $0.37 Median $0.83 Typical High $0.93 | Professional | None | $0.37 | $0.83 | $0.93 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.91 Median $0.95 Typical High $3.09 | Facility | None | $0.91 | $0.95 | $3.09 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.41 Median $0.98 Typical High $4.79 | Professional | None | $0.41 | $0.98 | $4.79 |
Tufts Setting Professional Modifier None Typical Low $0.59 Median $0.59 Typical High $0.59 | Professional | None | $0.59 | $0.59 | $0.59 |
United Setting Professional Modifier None Typical Low $0.32 Median $0.48 Typical High $0.93 | Professional | None | $0.32 | $0.48 | $0.93 |
Well Sense Setting Facility Modifier None Typical Low $0.79 Median $1.07 Typical High $1.62 | Facility | None | $0.79 | $1.07 | $1.62 |
Well Sense Setting Professional Modifier None Typical Low $0.59 Median $0.59 Typical High $0.71 | Professional | None | $0.59 | $0.59 | $0.71 |
4 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 52 · Reduced service Typical Low $0.21 Median $0.21 Typical High $0.93 | Professional | 52 · Reduced service | $0.21 | $0.21 | $0.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.37 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.37 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.28 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.19 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.19 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii 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· 13th of 51
$0.79
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.