How much rates vary
Facilitymedian $36 · 10th to 90th $15 to $162Professionalmedian $23 · 10th to 90th $10 to $60
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 $10.00 Median $39.81 Typical High $66.07 | Facility | None | $10.00 | $39.81 | $66.07 |
Aetna Setting Professional Modifier None Typical Low $10.00 Median $10.00 Typical High $44.67 | Professional | None | $10.00 | $10.00 | $44.67 |
AllWays Health Partners Setting Facility Modifier None Typical Low $61.66 Median $79.43 Typical High $138.04 | Facility | None | $61.66 | $79.43 | $138.04 |
AllWays Health Partners Setting Professional Modifier None Typical Low $14.13 Median $23.44 Typical High $61.66 | Professional | None | $14.13 | $23.44 | $61.66 |
BCBS Setting Facility Modifier None Typical Low $81.28 Median $93.33 Typical High $165.96 | Facility | None | $81.28 | $93.33 | $165.96 |
Cigna Setting Facility Modifier None Typical Low $23.99 Median $23.99 Typical High $23.99 | Facility | None | $23.99 | $23.99 | $23.99 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $22.91 Typical High $70.79 | Professional | None | $20.89 | $22.91 | $70.79 |
Fallon Health Setting Facility Modifier None Typical Low $14.79 Median $27.54 Typical High $39.81 | Facility | None | $14.79 | $27.54 | $39.81 |
Fallon Health Setting Professional Modifier None Typical Low $14.45 Median $25.12 Typical High $36.31 | Professional | None | $14.45 | $25.12 | $36.31 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $16.22 Median $26.92 Typical High $144.54 | Professional | None | $16.22 | $26.92 | $144.54 |
Health New England Setting Facility Modifier None Typical Low $34.67 Median $97.72 Typical High $147.91 | Facility | None | $34.67 | $97.72 | $147.91 |
Mass General Brigham Setting Facility Modifier None Typical Low $61.66 Median $79.43 Typical High $138.04 | Facility | None | $61.66 | $79.43 | $138.04 |
Mass General Brigham Setting Professional Modifier None Typical Low $14.13 Median $23.44 Typical High $61.66 | Professional | None | $14.13 | $23.44 | $61.66 |
Tufts Setting Facility Modifier None Typical Low $19.95 Median $95.50 Typical High $446.68 | Facility | None | $19.95 | $95.50 | $446.68 |
Tufts Setting Professional Modifier None Typical Low $18.20 Median $18.20 Typical High $20.42 | Professional | None | $18.20 | $18.20 | $20.42 |
United Setting Facility Modifier None Typical Low $100.00 Median $190.55 Typical High $281.84 | Facility | None | $100.00 | $190.55 | $281.84 |
United Setting Professional Modifier None Typical Low $12.02 Median $21.88 Typical High $79.43 | Professional | None | $12.02 | $21.88 | $79.43 |
Well Sense Setting Facility Modifier None Typical Low $20.42 Median $28.18 Typical High $41.69 | Facility | None | $20.42 | $28.18 | $41.69 |
Well Sense Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $20.42 | Professional | None | $16.98 | $16.98 | $20.42 |
5 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 $5.01 Median $5.01 Typical High $5.01 | Professional | 52 · Reduced service | $5.01 | $5.01 | $5.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.00 Median $2.00 Typical High $2.00 | Professional | 53 · Discontinued | $2.00 | $2.00 | $2.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.51 Median $1.51 Typical High $1.51 | Professional | 55 · Aftercare only | $1.51 | $1.51 | $1.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.00 Median $1.00 Typical High $1.00 | Professional | 56 · Pre-op care only | $1.00 | $1.00 | $1.00 |
Well Sense Setting Facility Modifier SL · State-supplied vaccine Typical Low $17.78 Median $21.88 Typical High $40.74 | Facility | SL · State-supplied vaccine | $17.78 | $21.88 | $40.74 |
Where Massachusetts sits
The same service costs 5.4 times more in Vermont than in Kansas. 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· 17th of 51
$28.18
VT $75.86KS $14.13
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.