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 $0.66 Median $0.66 Typical High $0.66 | Facility | None | $0.66 | $0.66 | $0.66 |
Aetna Setting Professional Modifier None Typical Low $0.66 Median $0.66 Typical High $0.66 | Professional | None | $0.66 | $0.66 | $0.66 |
AllWays Health Partners Setting Facility Modifier None Typical Low $1.12 Median $2.51 Typical High $3.31 | Facility | None | $1.12 | $2.51 | $3.31 |
AllWays Health Partners Setting Professional Modifier None Typical Low $0.56 Median $0.68 Typical High $1.12 | Professional | None | $0.56 | $0.68 | $1.12 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $2.00 Median $2.29 Typical High $4.17 | Facility | None | $2.00 | $2.29 | $4.17 |
Cigna Setting Facility Modifier None Typical Low $0.85 Median $1.38 Typical High $2.88 | Facility | None | $0.85 | $1.38 | $2.88 |
Cigna Setting Professional Modifier None Typical Low $0.66 Median $0.66 Typical High $0.81 | Professional | None | $0.66 | $0.66 | $0.81 |
Fallon Health Setting Facility Modifier None Typical Low $2.57 Median $3.16 Typical High $6,918.31 | Facility | None | $2.57 | $3.16 | $6,918.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $0.66 Median $0.68 Typical High $1.12 | Professional | None | $0.66 | $0.68 | $1.12 |
Mass General Brigham Setting Facility Modifier None Typical Low $1.12 Median $2.51 Typical High $3.31 | Facility | None | $1.12 | $2.51 | $3.31 |
Mass General Brigham Setting Professional Modifier None Typical Low $0.56 Median $0.68 Typical High $1.12 | Professional | None | $0.56 | $0.68 | $1.12 |
United Setting Facility Modifier None Typical Low $2.14 Median $2.14 Typical High $2.14 | Facility | None | $2.14 | $2.14 | $2.14 |
United Setting Professional Modifier None Typical Low $0.56 Median $0.68 Typical High $1.12 | Professional | None | $0.56 | $0.68 | $1.12 |
Well Sense Setting Facility Modifier None Typical Low $2,511.89 Median $3,467.37 Typical High $5,128.61 | Facility | None | $2,511.89 | $3,467.37 | $5,128.61 |
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 $0.33 Median $0.33 Typical High $0.33 | Professional | 52 · Reduced service | $0.33 | $0.33 | $0.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | 53 · Discontinued | $0.13 | $0.13 | $0.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.10 Median $0.10 Typical High $0.10 | Professional | 55 · Aftercare only | $0.10 | $0.10 | $0.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.07 Median $0.07 Typical High $0.07 | Professional | 56 · Pre-op care only | $0.07 | $0.07 | $0.07 |
Where Massachusetts sits
The same service costs 1.7 times more in South Carolina 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· 3rd of 51
$1.00
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.