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 $0.74 | Facility | None | $0.24 | $0.24 | $0.74 |
Aetna Setting Professional Modifier None Typical Low $0.24 Median $0.24 Typical High $0.26 | Professional | None | $0.24 | $0.24 | $0.26 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.05 Median $1.38 Typical High $3.24 | Facility | None | $1.05 | $1.38 | $3.24 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.30 Median $0.35 Typical High $1.00 | Professional | None | $0.30 | $0.35 | $1.00 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.28 Median $0.32 Typical High $0.58 | Facility | None | $0.28 | $0.32 | $0.58 |
Cigna Setting Facility Modifier None Typical Low $0.36 Median $0.59 Typical High $1.23 | Facility | None | $0.36 | $0.59 | $1.23 |
Cigna Setting Professional Modifier None Typical Low $0.28 Median $0.28 Typical High $0.35 | Professional | None | $0.28 | $0.28 | $0.35 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.28 Median $0.35 Typical High $0.59 | Professional | None | $0.28 | $0.35 | $0.59 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.05 Median $1.38 Typical High $3.24 | Facility | None | $1.05 | $1.38 | $3.24 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.30 Median $0.35 Typical High $1.00 | Professional | None | $0.30 | $0.35 | $1.00 |
United Setting Professional Modifier None Typical Low $0.30 Median $0.35 Typical High $0.59 | Professional | None | $0.30 | $0.35 | $0.59 |
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 4.4 times more in Kansas than in Utah. 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· 12th of 51
$0.35
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.