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 $0.05 Median $0.06 Typical High $0.12 | Facility | None | $0.05 | $0.06 | $0.12 |
Aetna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | None | $0.06 | $0.06 | $0.06 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.15 Median $0.20 Typical High $0.39 | Facility | None | $0.15 | $0.20 | $0.39 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.06 Median $0.08 Typical High $0.11 | Professional | None | $0.06 | $0.08 | $0.11 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.06 Median $0.06 Typical High $0.12 | Facility | None | $0.06 | $0.06 | $0.12 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.11 | Professional | None | $0.06 | $0.06 | $0.11 |
Cigna Setting Facility Modifier None Typical Low $0.08 Median $0.13 Typical High $0.26 | Facility | None | $0.08 | $0.13 | $0.26 |
Cigna Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.06 | Professional | None | $0.06 | $0.06 | $0.06 |
Fallon Health Setting Facility Modifier None Typical Low $0.06 Median $0.08 Typical High $0.09 | Facility | None | $0.06 | $0.08 | $0.09 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.06 Median $0.07 Typical High $0.08 | Professional | None | $0.06 | $0.07 | $0.08 |
Health New England Setting Facility Modifier None Typical Low $5.50 Median $7.94 Typical High $9.77 | Facility | None | $5.50 | $7.94 | $9.77 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.15 Median $0.20 Typical High $0.39 | Facility | None | $0.15 | $0.20 | $0.39 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.06 Median $0.08 Typical High $0.11 | Professional | None | $0.06 | $0.08 | $0.11 |
Tufts Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $9.77 | Facility | None | $9.77 | $9.77 | $9.77 |
United Setting Professional Modifier None Typical Low $0.08 Median $0.08 Typical High $0.12 | Professional | None | $0.08 | $0.08 | $0.12 |
Well Sense Setting Facility Modifier None Typical Low $0.08 Median $0.10 Typical High $0.18 | Facility | None | $0.08 | $0.10 | $0.18 |
Well Sense Setting Professional Modifier None Typical Low $0.06 Median $0.06 Typical High $0.08 | Professional | None | $0.06 | $0.06 | $0.08 |
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 $0.03 Median $0.03 Typical High $0.03 | Professional | 52 · Reduced service | $0.03 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $5.13 Typical High $5.13 | Professional | 53 · Discontinued | $5.13 | $5.13 | $5.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $3.89 Typical High $3.89 | Professional | 55 · Aftercare only | $3.89 | $3.89 | $3.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $2.57 Typical High $2.57 | Professional | 56 · Pre-op care only | $2.57 | $2.57 | $2.57 |
Where Massachusetts sits
The same service costs 8.5 times more in Wyoming than in New Jersey. 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· 17th of 51
$0.07
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.