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 $0.24 Median $0.24 Typical High $0.24 | Facility | None | $0.24 | $0.24 | $0.24 |
Aetna Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.24 | Professional | None | $0.24 | $0.24 | $0.24 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.24 Median $0.60 Typical High $0.78 | Facility | None | $0.24 | $0.60 | $0.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.23 Median $0.24 Typical High $0.35 | Professional | None | $0.23 | $0.24 | $0.35 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.27 Median $0.31 Typical High $0.56 | Facility | None | $0.27 | $0.31 | $0.56 |
Cigna Setting Facility Modifier None Typical Low $0.31 Median $0.50 Typical High $1.05 | Facility | None | $0.31 | $0.50 | $1.05 |
Cigna Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.30 | Professional | None | $0.24 | $0.24 | $0.30 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.23 Median $0.24 Typical High $0.39 | Professional | None | $0.23 | $0.24 | $0.39 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.24 Median $0.60 Typical High $0.78 | Facility | None | $0.24 | $0.60 | $0.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.23 Median $0.24 Typical High $0.35 | Professional | None | $0.23 | $0.24 | $0.35 |
United Setting Professional Modifier None Typical Low $0.23 Median $0.23 Typical High $0.39 | Professional | None | $0.23 | $0.23 | $0.39 |
Well Sense Setting Facility Modifier None Typical Low $0.24 Median $0.33 Typical High $0.54 | Facility | None | $0.24 | $0.33 | $0.54 |
Well Sense Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.28 | Professional | None | $0.24 | $0.24 | $0.28 |
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 $0.12 Median $0.12 Typical High $0.12 | Professional | 52 · Reduced service | $0.12 | $0.12 | $0.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 53 · Discontinued | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 55 · Aftercare only | $0.04 | $0.04 | $0.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 56 · Pre-op care only | $0.02 | $0.02 | $0.02 |
Where Massachusetts sits
The same service costs 1.8 times more in Arizona than in Hawaii. 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
$0.24
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.