How much rates vary
Facilitymedian $132 · 10th to 90th $72 to $295Professionalmedian $98 · 10th to 90th $87 to $162
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 $87.10 Median $114.82 Typical High $162.18 | Facility | None | $87.10 | $114.82 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $162.18 | Professional | None | $102.33 | $138.04 | $162.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $263.03 Median $295.12 Typical High $371.54 | Facility | None | $263.03 | $295.12 | $371.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $660.69 | Professional | None | $93.33 | $93.33 | $660.69 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $131.83 Median $213.80 Typical High $302.00 | Facility | None | $131.83 | $213.80 | $302.00 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $131.83 | Professional | None | $97.72 | $97.72 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $85.11 Typical High $125.89 | Professional | None | $57.54 | $85.11 | $125.89 |
Fallon Health Setting Facility Modifier None Typical Low $70.79 Median $123.03 Typical High $165.96 | Facility | None | $70.79 | $123.03 | $165.96 |
Fallon Health Setting Professional Modifier None Typical Low $91.20 Median $102.33 Typical High $128.82 | Professional | None | $91.20 | $102.33 | $128.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $87.10 Median $93.33 Typical High $123.03 | Professional | None | $87.10 | $93.33 | $123.03 |
Health New England Setting Facility Modifier None Typical Low $93.33 Median $104.71 Typical High $109.65 | Facility | None | $93.33 | $104.71 | $109.65 |
Health New England Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $575.44 | Professional | None | $93.33 | $93.33 | $575.44 |
Mass General Brigham Setting Facility Modifier None Typical Low $263.03 Median $295.12 Typical High $371.54 | Facility | None | $263.03 | $295.12 | $371.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $660.69 | Professional | None | $93.33 | $93.33 | $660.69 |
Tufts Setting Professional Modifier None Typical Low $70.79 Median $77.62 Typical High $77.62 | Professional | None | $70.79 | $77.62 | $77.62 |
United Setting Facility Modifier None Typical Low $245.47 Median $467.74 Typical High $691.83 | Facility | None | $245.47 | $467.74 | $691.83 |
United Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $123.03 | Professional | None | $93.33 | $93.33 | $123.03 |
Well Sense Setting Facility Modifier None Typical Low $72.44 Median $91.20 Typical High $165.96 | Facility | None | $72.44 | $91.20 | $165.96 |
Well Sense Setting Professional Modifier None Typical Low $37.15 Median $77.62 Typical High $93.33 | Professional | None | $37.15 | $77.62 | $93.33 |
29 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 AF · Specialist physician Typical Low $83.18 Median $104.71 Typical High $162.18 | Professional | AF · Specialist physician | $83.18 | $104.71 | $162.18 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $67.61 Median $120.23 Typical High $120.23 | Professional | HO · Master's level | $67.61 | $120.23 | $120.23 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $67.61 Median $138.04 Typical High $138.04 | Professional | TD · Registered nurse | $67.61 | $138.04 | $138.04 |
BCBS Massachusetts Setting Professional Modifier 54 · Surgery only Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | 54 · Surgery only | $69.18 | $69.18 | $69.18 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | 78 · Unplanned return to OR | $79.43 | $79.43 | $79.43 |
BCBS Massachusetts Setting Professional Modifier AS · PA/NP assist Typical Low $20.89 Median $20.89 Typical High $20.89 | Professional | AS · PA/NP assist | $20.89 | $20.89 | $20.89 |
Fallon Health Setting Facility Modifier HO · Master's level Typical Low $102.33 Median $107.15 Typical High $138.04 | Facility | HO · Master's level | $102.33 | $107.15 | $138.04 |
Fallon Health Setting Facility Modifier HP · Doctoral level Typical Low $102.33 Median $112.20 Typical High $194.98 | Facility | HP · Doctoral level | $102.33 | $112.20 | $194.98 |
Fallon Health Setting Facility Modifier SA · Nurse practitioner Typical Low $102.33 Median $109.65 Typical High $181.97 | Facility | SA · Nurse practitioner | $102.33 | $109.65 | $181.97 |
Fallon Health Setting Facility Modifier TD · Registered nurse Typical Low $104.71 Median $109.65 Typical High $165.96 | Facility | TD · Registered nurse | $104.71 | $109.65 | $165.96 |
Fallon Health Setting Facility Modifier U3 · State-defined Typical Low $50.12 Median $50.12 Typical High $60.26 | Facility | U3 · State-defined | $50.12 | $50.12 | $60.26 |
Fallon Health Setting Facility Modifier U4 · State-defined Typical Low $48.98 Median $48.98 Typical High $67.61 | Facility | U4 · State-defined | $48.98 | $48.98 | $67.61 |
Fallon Health Setting Facility Modifier U6 · State-defined Typical Low $114.82 Median $128.82 Typical High $213.80 | Facility | U6 · State-defined | $114.82 | $128.82 | $213.80 |
Fallon Health Setting Facility Modifier U7 · State-defined Typical Low $89.13 Median $89.13 Typical High $125.89 | Facility | U7 · State-defined | $89.13 | $89.13 | $125.89 |
Fallon Health Setting Facility Modifier UG · Afternoon Typical Low $141.25 Median $141.25 Typical High $169.82 | Facility | UG · Afternoon | $141.25 | $141.25 | $169.82 |
Fallon Health Setting Professional Modifier HO · Master's level Typical Low $91.20 Median $102.33 Typical High $102.33 | Professional | HO · Master's level | $91.20 | $102.33 | $102.33 |
Fallon Health Setting Professional Modifier HP · Doctoral level Typical Low $102.33 Median $112.20 Typical High $128.82 | Professional | HP · Doctoral level | $102.33 | $112.20 | $128.82 |
Fallon Health Setting Professional Modifier SA · Nurse practitioner Typical Low $104.71 Median $104.71 Typical High $109.65 | Professional | SA · Nurse practitioner | $104.71 | $104.71 | $109.65 |
Fallon Health Setting Professional Modifier TD · Registered nurse Typical Low $81.28 Median $104.71 Typical High $109.65 | Professional | TD · Registered nurse | $81.28 | $104.71 | $109.65 |
Fallon Health Setting Professional Modifier U3 · State-defined Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | U3 · State-defined | $50.12 | $50.12 | $50.12 |
Fallon Health Setting Professional Modifier U4 · State-defined Typical Low $48.98 Median $48.98 Typical High $48.98 | Professional | U4 · State-defined | $48.98 | $48.98 | $48.98 |
Fallon Health Setting Professional Modifier U6 · State-defined Typical Low $123.03 Median $123.03 Typical High $128.82 | Professional | U6 · State-defined | $123.03 | $123.03 | $128.82 |
Fallon Health Setting Professional Modifier U7 · State-defined Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | U7 · State-defined | $89.13 | $89.13 | $89.13 |
Fallon Health Setting Professional Modifier UG · Afternoon Typical Low $141.25 Median $141.25 Typical High $141.25 | Professional | UG · Afternoon | $141.25 | $141.25 | $141.25 |
Well Sense Setting Facility Modifier HN · Bachelor's level Typical Low $72.44 Median $72.44 Typical High $169.82 | Facility | HN · Bachelor's level | $72.44 | $72.44 | $169.82 |
Well Sense Setting Facility Modifier U3 · State-defined Typical Low $50.12 Median $60.26 Typical High $114.82 | Facility | U3 · State-defined | $50.12 | $60.26 | $114.82 |
Well Sense Setting Facility Modifier U4 · State-defined Typical Low $48.98 Median $58.88 Typical High $109.65 | Facility | U4 · State-defined | $48.98 | $58.88 | $109.65 |
Well Sense Setting Facility Modifier U6 · State-defined Typical Low $107.15 Median $128.82 Typical High $245.47 | Facility | U6 · State-defined | $107.15 | $128.82 | $245.47 |
Well Sense Setting Facility Modifier UG · Afternoon Typical Low $141.25 Median $169.82 Typical High $288.40 | Facility | UG · Afternoon | $141.25 | $169.82 | $288.40 |
Where Massachusetts sits
The same service costs 1.7 times more in Alaska than in Ohio. 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· 26th of 51
$97.72
AK $132OH $75.86
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.