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 $0.34 Median $0.34 Typical High $1.74 | Facility | None | $0.34 | $0.34 | $1.74 |
Aetna Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.35 | Professional | None | $0.34 | $0.34 | $0.35 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.47 Median $0.47 Typical High $1.70 | Facility | None | $0.47 | $0.47 | $1.70 |
AllWays Health Partners Setting Facility Modifier BO · Nutrition taken by mouth Typical Low $1.82 Median $1.82 Typical High $6.31 | Facility | BO · Nutrition taken by mouth | $1.82 | $1.82 | $6.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.19 Median $0.47 Typical High $1.12 | Professional | None | $0.19 | $0.47 | $1.12 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.83 Median $0.95 Typical High $1.70 | Facility | None | $0.83 | $0.95 | $1.70 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $0.34 | Professional | None | $0.33 | $0.33 | $0.34 |
Cigna Setting Professional Modifier None Typical Low $0.33 Median $0.33 Typical High $0.46 | Professional | None | $0.33 | $0.33 | $0.46 |
Fallon Health Setting Facility Modifier None Typical Low $60.26 Median $100.00 Typical High $8,511.38 | Facility | None | $60.26 | $100.00 | $8,511.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.18 Median $0.65 Typical High $1.12 | Professional | None | $0.18 | $0.65 | $1.12 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.47 Median $0.47 Typical High $1.70 | Facility | None | $0.47 | $0.47 | $1.70 |
Mass General Brigham Setting Facility Modifier BO · Nutrition taken by mouth Typical Low $1.82 Median $1.82 Typical High $6.31 | Facility | BO · Nutrition taken by mouth | $1.82 | $1.82 | $6.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.19 Median $0.47 Typical High $1.12 | Professional | None | $0.19 | $0.47 | $1.12 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.65 Typical High $1.12 | Professional | None | $0.18 | $0.65 | $1.12 |
Well Sense Setting Facility Modifier None Typical Low $0.31 Median $0.39 Typical High $0.62 | Facility | None | $0.31 | $0.39 | $0.62 |
Well Sense Setting Facility Modifier BO · Nutrition taken by mouth Typical Low $2.00 Median $2.51 Typical High $4.68 | Facility | BO · Nutrition taken by mouth | $2.00 | $2.51 | $4.68 |
Well Sense Setting Professional Modifier BO · Nutrition taken by mouth Typical Low $1.82 Median $1.82 Typical High $2.19 | Professional | BO · Nutrition taken by mouth | $1.82 | $1.82 | $2.19 |
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 $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.04 |
Well Sense Setting Facility Modifier BA · With IV/tube nutrition Typical Low $0.38 Median $0.52 Typical High $0.87 | Facility | BA · With IV/tube nutrition | $0.38 | $0.52 | $0.87 |
Where Massachusetts sits
The same service costs 3.0 times more in Florida than in Alabama. 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· 33rd of 51
$0.47
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.