How much rates vary
Facilitymedian $19 · 10th to 90th $11 to $49Professionalmedian $14 · 10th to 90th $7 to $42
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 $8.32 Median $23.44 Typical High $38.90 | Facility | None | $8.32 | $23.44 | $38.90 |
Aetna Setting Professional Modifier None Typical Low $8.32 Median $8.32 Typical High $17.78 | Professional | None | $8.32 | $8.32 | $17.78 |
AllWays Health Partners Setting Facility Modifier None Typical Low $9.12 Median $13.18 Typical High $35.48 | Facility | None | $9.12 | $13.18 | $35.48 |
AllWays Health Partners Setting Professional Modifier None Typical Low $6.31 Median $12.02 Typical High $30.90 | Professional | None | $6.31 | $12.02 | $30.90 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $11.48 Median $38.02 Typical High $54.95 | Facility | None | $11.48 | $38.02 | $54.95 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $11.22 | Professional | None | $11.22 | $11.22 | $11.22 |
Cigna Setting Facility Modifier None Typical Low $7.94 Median $17.38 Typical High $30.90 | Facility | None | $7.94 | $17.38 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $16.60 Median $19.05 Typical High $74.13 | Professional | None | $16.60 | $19.05 | $74.13 |
Fallon Health Setting Facility Modifier None Typical Low $13.80 Median $21.88 Typical High $48.98 | Facility | None | $13.80 | $21.88 | $48.98 |
Fallon Health Setting Professional Modifier None Typical Low $14.45 Median $22.91 Typical High $41.69 | Professional | None | $14.45 | $22.91 | $41.69 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $6.03 Median $12.02 Typical High $46.77 | Professional | None | $6.03 | $12.02 | $46.77 |
Health New England Setting Facility Modifier None Typical Low $11.22 Median $48.98 Typical High $457.09 | Facility | None | $11.22 | $48.98 | $457.09 |
Mass General Brigham Setting Facility Modifier None Typical Low $9.12 Median $13.18 Typical High $35.48 | Facility | None | $9.12 | $13.18 | $35.48 |
Mass General Brigham Setting Professional Modifier None Typical Low $6.31 Median $12.02 Typical High $30.90 | Professional | None | $6.31 | $12.02 | $30.90 |
Tufts Setting Facility Modifier None Typical Low $9.55 Median $16.98 Typical High $426.58 | Facility | None | $9.55 | $16.98 | $426.58 |
Tufts Setting Professional Modifier None Typical Low $8.91 Median $10.72 Typical High $19.50 | Professional | None | $8.91 | $10.72 | $19.50 |
United Setting Facility Modifier None Typical Low $12.02 Median $12.02 Typical High $23.99 | Facility | None | $12.02 | $12.02 | $23.99 |
United Setting Professional Modifier None Typical Low $4.79 Median $7.24 Typical High $50.12 | Professional | None | $4.79 | $7.24 | $50.12 |
Well Sense Setting Facility Modifier None Typical Low $9.12 Median $13.18 Typical High $20.89 | Facility | None | $9.12 | $13.18 | $20.89 |
Well Sense Setting Professional Modifier None Typical Low $9.12 Median $9.12 Typical High $10.96 | Professional | None | $9.12 | $9.12 | $10.96 |
3 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 $4.17 Median $4.17 Typical High $6.92 | Professional | 52 · Reduced service | $4.17 | $4.17 | $6.92 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.66 Median $1.66 Typical High $2.75 | Professional | 53 · Discontinued | $1.66 | $1.66 | $2.75 |
Fallon Health Setting Facility Modifier QW · Waived lab test Typical Low $12.02 Median $15.85 Typical High $18.62 | Facility | QW · Waived lab test | $12.02 | $15.85 | $18.62 |
Where Massachusetts sits
The same service costs 7.6 times more in Vermont than in Maryland. 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
$16.98
VT $72.44MD $9.55
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.