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 $0.47 Median $0.47 Typical High $2.45 | Facility | None | $0.47 | $0.47 | $2.45 |
Aetna Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.51 | Professional | None | $0.47 | $0.47 | $0.51 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.95 Median $0.95 Typical High $2.88 | Facility | None | $0.95 | $0.95 | $2.88 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.35 Median $0.95 Typical High $1.58 | Professional | None | $0.35 | $0.95 | $1.58 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $1.70 Median $1.91 Typical High $3.47 | Facility | None | $1.70 | $1.91 | $3.47 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | None | $0.07 | $0.07 | $0.07 |
Cigna Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $8.13 | Professional | None | $5.89 | $5.89 | $8.13 |
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 $0.33 Median $0.91 Typical High $2.04 | Professional | None | $0.33 | $0.91 | $2.04 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.95 Median $0.95 Typical High $2.88 | Facility | None | $0.95 | $0.95 | $2.88 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.35 Median $0.95 Typical High $1.58 | Professional | None | $0.35 | $0.95 | $1.58 |
United Setting Professional Modifier None Typical Low $0.33 Median $0.91 Typical High $2.04 | Professional | None | $0.33 | $0.91 | $2.04 |
Well Sense Setting Facility Modifier None Typical Low $0.56 Median $0.71 Typical High $1.15 | Facility | None | $0.56 | $0.71 | $1.15 |
Well Sense Setting Professional Modifier None Typical Low $0.10 Median $0.10 Typical High $0.12 | Professional | None | $0.10 | $0.10 | $0.12 |
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 $0.07 Median $0.07 Typical High $0.08 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Well Sense Setting Facility Modifier BA · With IV/tube nutrition Typical Low $0.78 Median $1.00 Typical High $1.78 | Facility | BA · With IV/tube nutrition | $0.78 | $1.00 | $1.78 |
Where Massachusetts sits
The same service costs 3.6 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· 23rd of 51
$0.95
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.