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 $0.48 Median $0.48 Typical High $1.66 | Facility | None | $0.48 | $0.48 | $1.66 |
Aetna Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
AllWays Health Partners Setting Facility Modifier None Typical Low $0.55 Median $4.79 Typical High $5.75 | Facility | None | $0.55 | $4.79 | $5.75 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.47 Median $0.55 Typical High $218.78 | Professional | None | $0.47 | $0.55 | $218.78 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $0.52 Median $0.60 Typical High $1.10 | Facility | None | $0.52 | $0.60 | $1.10 |
Cigna Setting Facility Modifier None Typical Low $0.62 Median $1.00 Typical High $2.09 | Facility | None | $0.62 | $1.00 | $2.09 |
Cigna Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.48 | Professional | None | $0.48 | $0.48 | $0.48 |
Fallon Health Setting Facility Modifier None Typical Low $0.95 Median $1.12 Typical High $5,888.44 | Facility | None | $0.95 | $1.12 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $0.95 Median $1.12 Typical High $1.12 | Professional | None | $0.95 | $1.12 | $1.12 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.47 Median $0.48 Typical High $0.48 | Professional | None | $0.47 | $0.48 | $0.48 |
Mass General Brigham Setting Facility Modifier None Typical Low $0.55 Median $4.79 Typical High $5.75 | Facility | None | $0.55 | $4.79 | $5.75 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.47 Median $0.55 Typical High $218.78 | Professional | None | $0.47 | $0.55 | $218.78 |
United Setting Professional Modifier None Typical Low $0.47 Median $0.47 Typical High $0.48 | Professional | None | $0.47 | $0.47 | $0.48 |
Well Sense Setting Facility Modifier None Typical Low $0.56 Median $0.78 Typical High $0.95 | Facility | None | $0.56 | $0.78 | $0.95 |
Well Sense Setting Professional Modifier None Typical Low $0.48 Median $0.48 Typical High $0.65 | Professional | None | $0.48 | $0.48 | $0.65 |
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 $0.24 Median $0.24 Typical High $0.24 | Professional | 52 · Reduced service | $0.24 | $0.24 | $0.24 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 53 · Discontinued | $0.10 | $0.10 | $0.10 |
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 $0.05 Median $0.05 Typical High $0.05 | Professional | 56 · Pre-op care only | $0.05 | $0.05 | $0.05 |
Where Massachusetts sits
The same service costs 2.3 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· 27th of 51
$0.48
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.