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 $0.60 Median $0.60 Typical High $3.16 | Facility | None | $0.60 | $0.60 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $0.60 Median $0.60 Typical High $0.63 | Professional | None | $0.60 | $0.60 | $0.63 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $2.45 | Facility | None | $0.81 | $0.81 | $2.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.32 Median $0.81 Typical High $2.00 | Professional | None | $0.32 | $0.81 | $2.00 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.98 Median $1.10 Typical High $2.00 | Facility | None | $0.98 | $1.10 | $2.00 |
Cigna Setting Professional Modifier None Typical Low $1.82 Median $1.82 Typical High $2.51 | Professional | None | $1.82 | $1.82 | $2.51 |
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 $0.32 Median $1.15 Typical High $2.00 | Professional | None | $0.32 | $1.15 | $2.00 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.81 Median $0.81 Typical High $2.45 | Facility | None | $0.81 | $0.81 | $2.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.32 Median $0.81 Typical High $2.00 | Professional | None | $0.32 | $0.81 | $2.00 |
United Setting Professional Modifier None Typical Low $0.32 Median $1.15 Typical High $2.00 | Professional | None | $0.32 | $1.15 | $2.00 |
Well Sense Setting Facility Modifier None Typical Low $0.55 Median $0.69 Typical High $1.10 | Facility | None | $0.55 | $0.69 | $1.10 |
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 55 · Aftercare only Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 55 · Aftercare only | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 56 · Pre-op care only | $0.06 | $0.06 | $0.06 |
Well Sense Setting Facility Modifier BA · With IV/tube nutrition Typical Low $0.65 Median $0.85 Typical High $1.51 | Facility | BA · With IV/tube nutrition | $0.65 | $0.85 | $1.51 |
Well Sense Setting Professional Modifier BA · With IV/tube nutrition Typical Low $1.00 Median $1.00 Typical High $1.20 | Professional | BA · With IV/tube nutrition | $1.00 | $1.00 | $1.20 |
Where Massachusetts sits
The same service costs 3.2 times more in Texas 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· 32nd of 51
$0.85
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.