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 $0.32 Median $0.32 Typical High $1.45 | Facility | None | $0.32 | $0.32 | $1.45 |
Aetna Setting Professional Modifier None Typical Low $0.32 Median $0.32 Typical High $1.45 | Professional | None | $0.32 | $0.32 | $1.45 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.65 Median $0.71 Typical High $2.34 | Facility | None | $0.65 | $0.71 | $2.34 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.28 Median $0.76 Typical High $3.89 | Professional | None | $0.28 | $0.76 | $3.89 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.81 Median $0.95 Typical High $1.26 | Facility | None | $0.81 | $0.95 | $1.26 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $0.43 Median $0.62 Typical High $0.62 | Professional | None | $0.43 | $0.62 | $0.62 |
Cigna Setting Facility Modifier None Typical Low $0.42 Median $0.42 Typical High $0.42 | Facility | None | $0.42 | $0.42 | $0.42 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.50 | Professional | None | $0.36 | $0.36 | $0.50 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.28 Median $0.65 Typical High $0.68 | Professional | None | $0.28 | $0.65 | $0.68 |
Health New England Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.65 Median $0.71 Typical High $2.34 | Facility | None | $0.65 | $0.71 | $2.34 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.28 Median $0.76 Typical High $3.89 | Professional | None | $0.28 | $0.76 | $3.89 |
United Setting Facility Modifier None Typical Low $0.91 Median $0.91 Typical High $0.91 | Facility | None | $0.91 | $0.91 | $0.91 |
United Setting Professional Modifier None Typical Low $0.24 Median $0.39 Typical High $0.72 | Professional | None | $0.24 | $0.39 | $0.72 |
Well Sense Setting Facility Modifier None Typical Low $0.74 Median $0.74 Typical High $2,884.03 | Facility | None | $0.74 | $0.74 | $2,884.03 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
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 $0.16 Median $0.16 Typical High $0.72 | Professional | 52 · Reduced service | $0.16 | $0.16 | $0.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.06 Typical High $0.28 | Professional | 53 · Discontinued | $0.06 | $0.06 | $0.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.22 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.03 Typical High $0.15 | Professional | 56 · Pre-op care only | $0.03 | $0.03 | $0.15 |
Where Massachusetts sits
The same service costs 2.3 times more in Montana 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· 14th of 51
$0.62
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.