How much rates vary
Facilitymedian $3 · 10th to 90th $2 to $78Professionalmedian $3 · 10th to 90th $2 to $5
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 $2.24 Median $2.51 Typical High $3.16 | Facility | None | $2.24 | $2.51 | $3.16 |
Aetna Setting Professional Modifier None Typical Low $2.24 Median $2.69 Typical High $3.31 | Professional | None | $2.24 | $2.69 | $3.31 |
AllWays Health Partners Setting Facility Modifier None Typical Low $5.37 Median $8.32 Typical High $46.77 | Facility | None | $5.37 | $8.32 | $46.77 |
AllWays Health Partners Setting Professional Modifier None Typical Low $2.69 Median $2.75 Typical High $13.80 | Professional | None | $2.69 | $2.75 | $13.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $275.42 | Facility | None | $91.20 | $91.20 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $2.00 Median $3.02 Typical High $5.01 | Professional | None | $2.00 | $3.02 | $5.01 |
Fallon Health Setting Facility Modifier None Typical Low $1.58 Median $3.24 Typical High $77.62 | Facility | None | $1.58 | $3.24 | $77.62 |
Fallon Health Setting Professional Modifier None Typical Low $1.86 Median $45.71 Typical High $45.71 | Professional | None | $1.86 | $45.71 | $45.71 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $2.14 Median $2.14 Typical High $3.47 | Professional | None | $2.14 | $2.14 | $3.47 |
Mass General Brigham Setting Facility Modifier None Typical Low $5.37 Median $8.32 Typical High $46.77 | Facility | None | $5.37 | $8.32 | $46.77 |
Mass General Brigham Setting Professional Modifier None Typical Low $2.69 Median $2.75 Typical High $13.80 | Professional | None | $2.69 | $2.75 | $13.80 |
United Setting Facility Modifier None Typical Low $40.74 Median $75.86 Typical High $114.82 | Facility | None | $40.74 | $75.86 | $114.82 |
United Setting Professional Modifier None Typical Low $2.63 Median $2.75 Typical High $3.55 | Professional | None | $2.63 | $2.75 | $3.55 |
Well Sense Setting Facility Modifier None Typical Low $1.82 Median $2.14 Typical High $3.55 | Facility | None | $1.82 | $2.14 | $3.55 |
Well Sense Setting Professional Modifier None Typical Low $1.74 Median $1.74 Typical High $2.04 | Professional | None | $1.74 | $1.74 | $2.04 |
7 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 $1.12 Median $1.12 Typical High $1.12 | Professional | 52 · Reduced service | $1.12 | $1.12 | $1.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.45 Median $0.45 Typical High $0.45 | Professional | 53 · Discontinued | $0.45 | $0.45 | $0.45 |
Aetna Setting Professional Modifier AF · Specialist physician Typical Low $3.16 Median $3.31 Typical High $3.31 | Professional | AF · Specialist physician | $3.16 | $3.31 | $3.31 |
Aetna Setting Professional Modifier HO · Master's level Typical Low $2.34 Median $2.51 Typical High $2.51 | Professional | HO · Master's level | $2.34 | $2.51 | $2.51 |
Aetna Setting Professional Modifier TD · Registered nurse Typical Low $2.69 Median $2.82 Typical High $2.82 | Professional | TD · Registered nurse | $2.69 | $2.82 | $2.82 |
Fallon Health Setting Facility Modifier HP · Doctoral level Typical Low $45.71 Median $45.71 Typical High $77.62 | Facility | HP · Doctoral level | $45.71 | $45.71 | $77.62 |
Fallon Health Setting Professional Modifier HP · Doctoral level Typical Low $2.51 Median $45.71 Typical High $45.71 | Professional | HP · Doctoral level | $2.51 | $45.71 | $45.71 |
Where Massachusetts sits
The same service costs 2.2 times more in North Dakota than in Kentucky. 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· 10th of 51
$2.69
ND $3.55KY $1.62
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.