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 $0.76 Median $1.07 Typical High $4.57 | Facility | None | $0.76 | $1.07 | $4.57 |
Aetna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $1.15 | Professional | None | $0.76 | $0.76 | $1.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.72 Median $2.24 Typical High $3.16 | Facility | None | $0.72 | $2.24 | $3.16 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.69 Median $0.76 Typical High $1.66 | Professional | None | $0.69 | $0.76 | $1.66 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.76 Median $0.85 Typical High $1.55 | Facility | None | $0.76 | $0.85 | $1.55 |
Cigna Setting Facility Modifier None Typical Low $0.98 Median $1.58 Typical High $3.24 | Facility | None | $0.98 | $1.58 | $3.24 |
Cigna Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.93 | Professional | None | $0.76 | $0.76 | $0.93 |
Fallon Health Setting Facility Modifier None Typical Low $0.76 Median $0.98 Typical High $1.15 | Facility | None | $0.76 | $0.98 | $1.15 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.69 Median $0.76 Typical High $1.66 | Professional | None | $0.69 | $0.76 | $1.66 |
Health New England Setting Facility Modifier None Typical Low $0.74 Median $1.15 Typical High $2.75 | Facility | None | $0.74 | $1.15 | $2.75 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.72 Median $2.24 Typical High $3.16 | Facility | None | $0.72 | $2.24 | $3.16 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.69 Median $0.76 Typical High $1.66 | Professional | None | $0.69 | $0.76 | $1.66 |
Tufts Setting Facility Modifier None Typical Low $0.78 Median $0.78 Typical High $0.85 | Facility | None | $0.78 | $0.78 | $0.85 |
United Setting Professional Modifier None Typical Low $0.69 Median $0.72 Typical High $2.14 | Professional | None | $0.69 | $0.72 | $2.14 |
Well Sense Setting Facility Modifier None Typical Low $0.76 Median $1.10 Typical High $1.74 | Facility | None | $0.76 | $1.10 | $1.74 |
Well Sense Setting Professional Modifier None Typical Low $0.76 Median $0.76 Typical High $0.89 | Professional | None | $0.76 | $0.76 | $0.89 |
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 $0.38 Median $0.38 Typical High $0.39 | Professional | 52 · Reduced service | $0.38 | $0.38 | $0.39 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.15 Median $0.15 Typical High $0.16 | Professional | 53 · Discontinued | $0.15 | $0.15 | $0.16 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.11 Median $0.11 Typical High $0.12 | Professional | 55 · Aftercare only | $0.11 | $0.11 | $0.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.08 Median $0.08 Typical High $0.08 | Professional | 56 · Pre-op care only | $0.08 | $0.08 | $0.08 |
Where Massachusetts sits
The same service costs 5.2 times more in Vermont than in Rhode Island. 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· 30th of 51
$0.81
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.