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 $0.40 Median $0.40 Typical High $6.03 | Facility | None | $0.40 | $0.40 | $6.03 |
Aetna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.71 | Professional | None | $0.40 | $0.40 | $0.71 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.66 Median $1.00 Typical High $1.29 | Facility | None | $0.66 | $1.00 | $1.29 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.40 Median $0.43 Typical High $5.25 | Professional | None | $0.40 | $0.43 | $5.25 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.40 Median $0.46 Typical High $0.83 | Facility | None | $0.40 | $0.46 | $0.83 |
Cigna Setting Facility Modifier None Typical Low $0.52 Median $0.83 Typical High $1.74 | Facility | None | $0.52 | $0.83 | $1.74 |
Cigna Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.55 | Professional | None | $0.40 | $0.40 | $0.55 |
Fallon Health Setting Facility Modifier None Typical Low $0.40 Median $0.52 Typical High $0.62 | Facility | None | $0.40 | $0.52 | $0.62 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.40 Median $0.43 Typical High $1.32 | Professional | None | $0.40 | $0.43 | $1.32 |
Health New England Setting Facility Modifier None Typical Low $2.19 Median $3.09 Typical High $7.41 | Facility | None | $2.19 | $3.09 | $7.41 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.66 Median $1.00 Typical High $1.29 | Facility | None | $0.66 | $1.00 | $1.29 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.40 Median $0.43 Typical High $5.25 | Professional | None | $0.40 | $0.43 | $5.25 |
Tufts Setting Facility Modifier None Typical Low $0.93 Median $0.93 Typical High $1.02 | Facility | None | $0.93 | $0.93 | $1.02 |
United Setting Professional Modifier None Typical Low $0.43 Median $0.43 Typical High $5.25 | Professional | None | $0.43 | $0.43 | $5.25 |
Well Sense Setting Facility Modifier None Typical Low $0.43 Median $0.60 Typical High $0.93 | Facility | None | $0.43 | $0.60 | $0.93 |
Well Sense Setting Professional Modifier None Typical Low $0.40 Median $0.40 Typical High $0.48 | Professional | None | $0.40 | $0.40 | $0.48 |
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 $0.21 | Professional | 52 · Reduced service | $0.20 | $0.20 | $0.21 |
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 4.0 times more in Texas than in Georgia. 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· 25th of 51
$0.46
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.