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 $0.39 Median $0.39 Typical High $0.39 | Facility | None | $0.39 | $0.39 | $0.39 |
Aetna Setting Professional Modifier None Typical Low $0.39 Median $0.39 Typical High $0.39 | Professional | None | $0.39 | $0.39 | $0.39 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.69 Median $1.74 Typical High $2.24 | Facility | None | $0.69 | $1.74 | $2.24 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.38 Median $0.52 Typical High $1.07 | Professional | None | $0.38 | $0.52 | $1.07 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.30 Median $0.34 Typical High $0.62 | Facility | None | $0.30 | $0.34 | $0.62 |
Cigna Setting Facility Modifier None Typical Low $0.35 Median $0.56 Typical High $1.17 | Facility | None | $0.35 | $0.56 | $1.17 |
Cigna Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.85 | Professional | None | $0.27 | $0.27 | $0.85 |
Fallon Health Setting Facility Modifier None Typical Low $0.79 Median $0.79 Typical High $0.83 | Facility | None | $0.79 | $0.79 | $0.83 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.38 Median $0.39 Typical High $1.02 | Professional | None | $0.38 | $0.39 | $1.02 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.69 Median $1.74 Typical High $2.24 | Facility | None | $0.69 | $1.74 | $2.24 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.38 Median $0.52 Typical High $1.07 | Professional | None | $0.38 | $0.52 | $1.07 |
United Setting Professional Modifier None Typical Low $0.38 Median $0.38 Typical High $1.07 | Professional | None | $0.38 | $0.38 | $1.07 |
Well Sense Setting Facility Modifier None Typical Low $0.34 Median $0.49 Typical High $0.78 | Facility | None | $0.34 | $0.49 | $0.78 |
Well Sense Setting Professional Modifier None Typical Low $0.27 Median $0.27 Typical High $0.32 | Professional | None | $0.27 | $0.27 | $0.32 |
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 $0.20 Median $0.20 Typical High $0.20 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 53 · Discontinued | $0.08 | $0.08 | $0.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | 55 · Aftercare only | $0.06 | $0.06 | $0.06 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where Massachusetts sits
The same service costs 6.3 times more in Kansas than in Virginia. 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· 22nd of 51
$0.39
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.