How much rates vary
Facilitymedian $15 · 10th to 90th $8 to $35Professionalmedian $13 · 10th to 90th $11 to $21
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 $12.02 Median $15.85 Typical High $21.38 | Facility | None | $12.02 | $15.85 | $21.38 |
Aetna Setting Professional Modifier None Typical Low $14.13 Median $18.20 Typical High $21.38 | Professional | None | $14.13 | $18.20 | $21.38 |
AllWays Health Partners Setting Facility Modifier None Typical Low $13.18 Median $30.90 Typical High $37.15 | Facility | None | $13.18 | $30.90 | $37.15 |
AllWays Health Partners Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $37.15 | Professional | None | $13.49 | $13.49 | $37.15 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $15.14 Median $33.11 Typical High $44.67 | Facility | None | $15.14 | $33.11 | $44.67 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $11.22 Median $12.88 Typical High $17.38 | Professional | None | $11.22 | $12.88 | $17.38 |
Cigna Setting Professional Modifier None Typical Low $2.82 Median $10.96 Typical High $15.85 | Professional | None | $2.82 | $10.96 | $15.85 |
Fallon Health Setting Facility Modifier None Typical Low $6.61 Median $13.49 Typical High $19.05 | Facility | None | $6.61 | $13.49 | $19.05 |
Fallon Health Setting Professional Modifier None Typical Low $5.01 Median $13.18 Typical High $17.38 | Professional | None | $5.01 | $13.18 | $17.38 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $10.72 Median $13.49 Typical High $17.78 | Professional | None | $10.72 | $13.49 | $17.78 |
Health New England Setting Professional Modifier None Typical Low $12.02 Median $15.14 Typical High $21.38 | Professional | None | $12.02 | $15.14 | $21.38 |
Mass General Brigham Setting Facility Modifier None Typical Low $13.18 Median $30.90 Typical High $37.15 | Facility | None | $13.18 | $30.90 | $37.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $37.15 | Professional | None | $13.49 | $13.49 | $37.15 |
Tufts Setting Professional Modifier None Typical Low $10.96 Median $10.96 Typical High $10.96 | Professional | None | $10.96 | $10.96 | $10.96 |
United Setting Professional Modifier None Typical Low $13.49 Median $13.49 Typical High $17.38 | Professional | None | $13.49 | $13.49 | $17.38 |
Well Sense Setting Facility Modifier None Typical Low $10.96 Median $13.18 Typical High $22.39 | Facility | None | $10.96 | $13.18 | $22.39 |
Well Sense Setting Professional Modifier None Typical Low $3.63 Median $4.37 Typical High $11.48 | Professional | None | $3.63 | $4.37 | $11.48 |
12 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 |
|---|---|---|---|---|---|
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $10.47 Median $10.47 Typical High $10.47 | Professional | 78 · Unplanned return to OR | $10.47 | $10.47 | $10.47 |
Fallon Health Setting Facility Modifier HO · Master's level Typical Low $10.00 Median $12.88 Typical High $14.13 | Facility | HO · Master's level | $10.00 | $12.88 | $14.13 |
Fallon Health Setting Facility Modifier HP · Doctoral level Typical Low $6.46 Median $17.38 Typical High $19.95 | Facility | HP · Doctoral level | $6.46 | $17.38 | $19.95 |
Fallon Health Setting Facility Modifier SA · Nurse practitioner Typical Low $10.00 Median $14.45 Typical High $16.22 | Facility | SA · Nurse practitioner | $10.00 | $14.45 | $16.22 |
Fallon Health Setting Facility Modifier TD · Registered nurse Typical Low $6.17 Median $14.13 Typical High $14.79 | Facility | TD · Registered nurse | $6.17 | $14.13 | $14.79 |
Fallon Health Setting Facility Modifier U6 · State-defined Typical Low $10.00 Median $17.38 Typical High $19.05 | Facility | U6 · State-defined | $10.00 | $17.38 | $19.05 |
Fallon Health Setting Professional Modifier HO · Master's level Typical Low $12.30 Median $12.30 Typical High $13.18 | Professional | HO · Master's level | $12.30 | $12.30 | $13.18 |
Fallon Health Setting Professional Modifier HP · Doctoral level Typical Low $16.60 Median $16.60 Typical High $16.60 | Professional | HP · Doctoral level | $16.60 | $16.60 | $16.60 |
Fallon Health Setting Professional Modifier SA · Nurse practitioner Typical Low $14.13 Median $14.13 Typical High $14.79 | Professional | SA · Nurse practitioner | $14.13 | $14.13 | $14.79 |
Fallon Health Setting Professional Modifier TD · Registered nurse Typical Low $5.01 Median $14.13 Typical High $14.79 | Professional | TD · Registered nurse | $5.01 | $14.13 | $14.79 |
Fallon Health Setting Professional Modifier U6 · State-defined Typical Low $16.60 Median $16.60 Typical High $17.38 | Professional | U6 · State-defined | $16.60 | $16.60 | $17.38 |
Fallon Health Setting Professional Modifier U7 · State-defined Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | U7 · State-defined | $5.01 | $5.01 | $5.01 |
Where Massachusetts sits
The same service costs 1.8 times more in Alaska than in Georgia. 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
$13.49
AK $18.20GA $10.00
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.