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 $0.36 Median $0.36 Typical High $0.36 | Facility | None | $0.36 | $0.36 | $0.36 |
Aetna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.35 Median $0.49 Typical High $851.14 | Professional | None | $0.35 | $0.49 | $851.14 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.40 Median $0.46 Typical High $0.83 | Facility | None | $0.40 | $0.46 | $0.83 |
Cigna Setting Facility Modifier None Typical Low $0.46 Median $0.76 Typical High $1.55 | Facility | None | $0.46 | $0.76 | $1.55 |
Cigna Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.36 | Professional | None | $0.36 | $0.36 | $0.36 |
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 $0.35 Median $0.36 Typical High $0.36 | Professional | None | $0.35 | $0.36 | $0.36 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.35 Median $0.49 Typical High $851.14 | Professional | None | $0.35 | $0.49 | $851.14 |
United Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.36 | Professional | None | $0.35 | $0.35 | $0.36 |
Well Sense Setting Facility Modifier None Typical Low $0.36 Median $0.50 Typical High $0.81 | Facility | None | $0.36 | $0.50 | $0.81 |
Well Sense Setting Professional Modifier None Typical Low $0.36 Median $0.36 Typical High $0.49 | Professional | None | $0.36 | $0.36 | $0.49 |
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 $0.18 Median $0.18 Typical High $0.18 | Professional | 52 · Reduced service | $0.18 | $0.18 | $0.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 53 · Discontinued | $0.07 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.05 Typical High $0.05 | Professional | 55 · Aftercare only | $0.05 | $0.05 | $0.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.04 | $0.04 | $0.04 |
Where Massachusetts sits
The same service costs 1.6 times more in Alaska 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· 30th of 51
$0.36
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.