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 $0.44 Median $0.44 Typical High $0.56 | Facility | None | $0.44 | $0.44 | $0.56 |
Aetna Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.56 | Professional | None | $0.44 | $0.44 | $0.56 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.23 Median $1.10 Typical High $1.45 | Facility | None | $0.23 | $1.10 | $1.45 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.18 Median $0.44 Typical High $0.85 | Professional | None | $0.18 | $0.44 | $0.85 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.44 Median $0.50 Typical High $0.91 | Facility | None | $0.44 | $0.50 | $0.91 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.44 | Professional | None | $0.44 | $0.44 | $0.44 |
Cigna Setting Facility Modifier None Typical Low $0.56 Median $0.91 Typical High $1.91 | Facility | None | $0.56 | $0.91 | $1.91 |
Cigna Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.54 | Professional | None | $0.44 | $0.44 | $0.54 |
Fallon Health Setting Facility Modifier None Typical Low $0.44 Median $0.56 Typical High $0.68 | Facility | None | $0.44 | $0.56 | $0.68 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.18 Median $0.44 Typical High $0.93 | Professional | None | $0.18 | $0.44 | $0.93 |
Health New England Setting Facility Modifier None Typical Low $0.46 Median $0.46 Typical High $0.55 | Facility | None | $0.46 | $0.46 | $0.55 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.23 Median $1.10 Typical High $1.45 | Facility | None | $0.23 | $1.10 | $1.45 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.18 Median $0.44 Typical High $0.85 | Professional | None | $0.18 | $0.44 | $0.85 |
United Setting Professional Modifier None Typical Low $0.18 Median $0.44 Typical High $2.63 | Professional | None | $0.18 | $0.44 | $2.63 |
Well Sense Setting Facility Modifier None Typical Low $0.44 Median $0.62 Typical High $1.00 | Facility | None | $0.44 | $0.62 | $1.00 |
Well Sense Setting Professional Modifier None Typical Low $0.44 Median $0.44 Typical High $0.52 | Professional | None | $0.44 | $0.44 | $0.52 |
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 $0.22 Median $0.22 Typical High $0.24 | Professional | 52 · Reduced service | $0.22 | $0.22 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.09 Median $0.09 Typical High $0.09 | Professional | 53 · Discontinued | $0.09 | $0.09 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 55 · Aftercare only | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.05 |
Where Massachusetts sits
The same service costs 1.6 times more in Alaska than in Montana. 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· 33rd of 51
$0.44
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.