How much rates vary
Facilitymedian $59 · 10th to 90th $18 to $3,467Professionalmedian $18 · 10th to 90th $14 to $93
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 $18.20 Median $18.20 Typical High $147.91 | Facility | None | $18.20 | $18.20 | $147.91 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $18.20 Typical High $18.20 | Professional | None | $15.85 | $18.20 | $18.20 |
AllWays Health Partners Setting Facility Modifier None Typical Low $48.98 Median $77.62 Typical High $100.00 | Facility | None | $48.98 | $77.62 | $100.00 |
AllWays Health Partners Setting Professional Modifier None Typical Low $17.38 Median $144.54 Typical High $173.78 | Professional | None | $17.38 | $144.54 | $173.78 |
AllWays Health Partners Setting Professional Modifier HM · Below bachelor's level Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | HM · Below bachelor's level | $15.14 | $15.14 | $15.14 |
AllWays Health Partners Setting Professional Modifier HN · Bachelor's level Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | HN · Bachelor's level | $16.98 | $16.98 | $16.98 |
AllWays Health Partners Setting Professional Modifier HO · Master's level Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | HO · Master's level | $19.95 | $19.95 | $19.95 |
AllWays Health Partners Setting Professional Modifier HP · Doctoral level Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | HP · Doctoral level | $19.95 | $19.95 | $19.95 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $46.77 Median $58.88 Typical High $79.43 | Facility | None | $46.77 | $58.88 | $79.43 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $16.22 | Professional | None | $15.49 | $15.49 | $16.22 |
Cigna Setting Professional Modifier None Typical Low $10.00 Median $42.66 Typical High $45.71 | Professional | None | $10.00 | $42.66 | $45.71 |
Fallon Health Setting Facility Modifier None Typical Low $47.86 Median $56.23 Typical High $5,888.44 | Facility | None | $47.86 | $56.23 | $5,888.44 |
Fallon Health Setting Professional Modifier None Typical Low $16.22 Median $47.86 Typical High $56.23 | Professional | None | $16.22 | $47.86 | $56.23 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $14.13 Median $14.13 Typical High $32.36 | Professional | None | $14.13 | $14.13 | $32.36 |
Harvard Pilgrim Setting Professional Modifier HM · Below bachelor's level Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | HM · Below bachelor's level | $15.14 | $15.14 | $15.14 |
Harvard Pilgrim Setting Professional Modifier HN · Bachelor's level Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | HN · Bachelor's level | $16.98 | $16.98 | $16.98 |
Harvard Pilgrim Setting Professional Modifier HO · Master's level Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | HO · Master's level | $19.95 | $19.95 | $19.95 |
Harvard Pilgrim Setting Professional Modifier HP · Doctoral level Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | HP · Doctoral level | $19.95 | $19.95 | $19.95 |
Health New England Setting Professional Modifier None Typical Low $66.07 Median $181.97 Typical High $263.03 | Professional | None | $66.07 | $181.97 | $263.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $48.98 Median $77.62 Typical High $100.00 | Facility | None | $48.98 | $77.62 | $100.00 |
Mass General Brigham Setting Professional Modifier None Typical Low $17.38 Median $144.54 Typical High $173.78 | Professional | None | $17.38 | $144.54 | $173.78 |
Mass General Brigham Setting Professional Modifier HM · Below bachelor's level Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | HM · Below bachelor's level | $15.14 | $15.14 | $15.14 |
Mass General Brigham Setting Professional Modifier HN · Bachelor's level Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | HN · Bachelor's level | $16.98 | $16.98 | $16.98 |
Mass General Brigham Setting Professional Modifier HO · Master's level Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | HO · Master's level | $19.95 | $19.95 | $19.95 |
Mass General Brigham Setting Professional Modifier HP · Doctoral level Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | HP · Doctoral level | $19.95 | $19.95 | $19.95 |
Tufts Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | None | $16.22 | $16.22 | $16.22 |
United Setting Facility Modifier None Typical Low $141.25 Median $269.15 Typical High $398.11 | Facility | None | $141.25 | $269.15 | $398.11 |
United Setting Professional Modifier None Typical Low $32.36 Median $48.98 Typical High $138.04 | Professional | None | $32.36 | $48.98 | $138.04 |
United Setting Professional Modifier HM · Below bachelor's level Typical Low $15.14 Median $15.14 Typical High $15.14 | Professional | HM · Below bachelor's level | $15.14 | $15.14 | $15.14 |
United Setting Professional Modifier HN · Bachelor's level Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | HN · Bachelor's level | $16.98 | $16.98 | $16.98 |
United Setting Professional Modifier HO · Master's level Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | HO · Master's level | $19.95 | $19.95 | $19.95 |
United Setting Professional Modifier HP · Doctoral level Typical Low $19.95 Median $19.95 Typical High $19.95 | Professional | HP · Doctoral level | $19.95 | $19.95 | $19.95 |
Well Sense Setting Facility Modifier None Typical Low $16.22 Median $2,137.96 Typical High $4,897.79 | Facility | None | $16.22 | $2,137.96 | $4,897.79 |
Well Sense Setting Professional Modifier None Typical Low $2,511.89 Median $2,511.89 Typical High $3,019.95 | Professional | None | $2,511.89 | $2,511.89 | $3,019.95 |
4 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 53 · Discontinued Typical Low $4.07 Median $4.07 Typical High $4.07 | Professional | 53 · Discontinued | $4.07 | $4.07 | $4.07 |
BCBS Massachusetts Setting Professional Modifier 56 · Pre-op care only Typical Low $1.62 Median $1.62 Typical High $1.62 | Professional | 56 · Pre-op care only | $1.62 | $1.62 | $1.62 |
Fallon Health Setting Professional Modifier TL · Early intervention Typical Low $16.22 Median $16.22 Typical High $16.22 | Professional | TL · Early intervention | $16.22 | $16.22 | $16.22 |
Well Sense Setting Facility Modifier TM · School education plan Typical Low $25.70 Median $25.70 Typical High $25.70 | Facility | TM · School education plan | $25.70 | $25.70 | $25.70 |
Where Massachusetts sits
The same service costs 4.5 times more in Wyoming than in West Virginia. 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· 16th of 51
$18.20
WY $48.98WV $10.96
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.