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 $0.10 Median $0.34 Typical High $0.35 | Facility | None | $0.10 | $0.34 | $0.35 |
Aetna Setting Professional Modifier None Typical Low $0.33 Median $0.35 Typical High $0.35 | Professional | None | $0.33 | $0.35 | $0.35 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.11 Median $0.35 Typical High $0.35 | Facility | None | $0.11 | $0.35 | $0.35 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.34 Median $0.35 Typical High $41.69 | Professional | None | $0.34 | $0.35 | $41.69 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.39 Median $0.44 Typical High $0.79 | Facility | None | $0.39 | $0.44 | $0.79 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $0.34 Median $0.39 Typical High $0.63 | Professional | None | $0.34 | $0.39 | $0.63 |
Cigna Setting Facility Modifier None Typical Low $0.45 Median $0.72 Typical High $1.51 | Facility | None | $0.45 | $0.72 | $1.51 |
Cigna Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.35 | Professional | None | $0.35 | $0.35 | $0.35 |
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 $0.34 Median $0.35 Typical High $0.35 | Professional | None | $0.34 | $0.35 | $0.35 |
Health New England Setting Facility Modifier None Typical Low $3.47 Median $3.80 Typical High $4.17 | Facility | None | $3.47 | $3.80 | $4.17 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.11 Median $0.35 Typical High $0.35 | Facility | None | $0.11 | $0.35 | $0.35 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.34 Median $0.35 Typical High $41.69 | Professional | None | $0.34 | $0.35 | $41.69 |
United Setting Professional Modifier None Typical Low $0.34 Median $0.34 Typical High $0.38 | Professional | None | $0.34 | $0.34 | $0.38 |
Well Sense Setting Facility Modifier None Typical Low $0.41 Median $0.49 Typical High $0.72 | Facility | None | $0.41 | $0.49 | $0.72 |
Well Sense Setting Professional Modifier None Typical Low $0.35 Median $0.35 Typical High $0.47 | Professional | None | $0.35 | $0.35 | $0.47 |
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 $0.17 Median $0.18 Typical High $0.18 | Professional | 52 · Reduced service | $0.17 | $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 Montana than in Michigan. 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· 13th 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.