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 $0.71 Median $0.71 Typical High $0.71 | Facility | None | $0.71 | $0.71 | $0.71 |
Aetna Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.71 | Professional | None | $0.71 | $0.71 | $0.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.72 Median $1.82 Typical High $2.34 | Facility | None | $0.72 | $1.82 | $2.34 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.68 Median $0.71 Typical High $1.02 | Professional | None | $0.68 | $0.71 | $1.02 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.78 Median $0.89 Typical High $1.62 | Facility | None | $0.78 | $0.89 | $1.62 |
Cigna Setting Facility Modifier None Typical Low $0.89 Median $1.48 Typical High $3.02 | Facility | None | $0.89 | $1.48 | $3.02 |
Cigna Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.87 | Professional | None | $0.71 | $0.71 | $0.87 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.68 Median $0.72 Typical High $1.15 | Professional | None | $0.68 | $0.72 | $1.15 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.72 Median $1.82 Typical High $2.34 | Facility | None | $0.72 | $1.82 | $2.34 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.68 Median $0.71 Typical High $1.02 | Professional | None | $0.68 | $0.71 | $1.02 |
United Setting Professional Modifier None Typical Low $0.68 Median $0.68 Typical High $1.15 | Professional | None | $0.68 | $0.68 | $1.15 |
Well Sense Setting Facility Modifier None Typical Low $0.78 Median $0.95 Typical High $1.45 | Facility | None | $0.78 | $0.95 | $1.45 |
Well Sense Setting Professional Modifier None Typical Low $0.71 Median $0.71 Typical High $0.83 | Professional | None | $0.71 | $0.71 | $0.83 |
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 $0.35 Median $0.35 Typical High $0.35 | Professional | 52 · Reduced service | $0.35 | $0.35 | $0.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.14 Median $0.14 Typical High $0.14 | Professional | 53 · Discontinued | $0.14 | $0.14 | $0.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.11 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Where Massachusetts sits
The same service costs 1.7 times more in Arizona than in North Dakota. 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· 18th of 51
$0.72
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.