How much rates vary
Facilitymedian $56 · 10th to 90th $28 to $145Professionalmedian $89 · 10th to 90th $48 to $214
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 $47.86 Median $74.13 Typical High $112.20 | Facility | None | $47.86 | $74.13 | $112.20 |
Aetna Setting Professional Modifier None Typical Low $47.86 Median $85.11 Typical High $123.03 | Professional | None | $47.86 | $85.11 | $123.03 |
AllWays Health Partners Setting Facility Modifier None Typical Low $41.69 Median $79.43 Typical High $138.04 | Facility | None | $41.69 | $79.43 | $138.04 |
AllWays Health Partners Setting Professional Modifier None Typical Low $56.23 Median $114.82 Typical High $457.09 | Professional | None | $56.23 | $114.82 | $457.09 |
AllWays Health Partners Setting Professional Modifier 25 · Same-day visit Typical Low $28.18 Median $53.70 Typical High $104.71 | Professional | 25 · Same-day visit | $28.18 | $53.70 | $104.71 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $45.71 Median $120.23 Typical High $162.18 | Facility | None | $45.71 | $120.23 | $162.18 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $45.71 Median $87.10 Typical High $151.36 | Professional | None | $45.71 | $87.10 | $151.36 |
Cigna Setting Facility Modifier None Typical Low $151.36 Median $199.53 Typical High $223.87 | Facility | None | $151.36 | $199.53 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $83.18 Typical High $158.49 | Professional | None | $52.48 | $83.18 | $158.49 |
Fallon Health Setting Facility Modifier None Typical Low $25.12 Median $39.81 Typical High $66.07 | Facility | None | $25.12 | $39.81 | $66.07 |
Fallon Health Setting Professional Modifier None Typical Low $50.12 Median $79.43 Typical High $128.82 | Professional | None | $50.12 | $79.43 | $128.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $48.98 Median $100.00 Typical High $208.93 | Professional | None | $48.98 | $100.00 | $208.93 |
Health New England Setting Facility Modifier None Typical Low $79.43 Median $100.00 Typical High $234.42 | Facility | None | $79.43 | $100.00 | $234.42 |
Health New England Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $501.19 | Professional | None | $89.13 | $125.89 | $501.19 |
Mass General Brigham Setting Facility Modifier None Typical Low $41.69 Median $79.43 Typical High $138.04 | Facility | None | $41.69 | $79.43 | $138.04 |
Mass General Brigham Setting Professional Modifier None Typical Low $56.23 Median $114.82 Typical High $457.09 | Professional | None | $56.23 | $114.82 | $457.09 |
Mass General Brigham Setting Professional Modifier 25 · Same-day visit Typical Low $28.18 Median $53.70 Typical High $104.71 | Professional | 25 · Same-day visit | $28.18 | $53.70 | $104.71 |
Tufts Setting Facility Modifier None Typical Low $26.92 Median $44.67 Typical High $812.83 | Facility | None | $26.92 | $44.67 | $812.83 |
Tufts Setting Professional Modifier None Typical Low $74.13 Median $95.50 Typical High $138.04 | Professional | None | $74.13 | $95.50 | $138.04 |
United Setting Professional Modifier None Typical Low $53.70 Median $89.13 Typical High $199.53 | Professional | None | $53.70 | $89.13 | $199.53 |
Well Sense Setting Facility Modifier None Typical Low $50.12 Median $74.13 Typical High $117.49 | Facility | None | $50.12 | $74.13 | $117.49 |
Well Sense Setting Professional Modifier None Typical Low $34.67 Median $34.67 Typical High $41.69 | Professional | None | $34.67 | $34.67 | $41.69 |
20 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 $23.99 Median $32.36 Typical High $37.15 | Professional | 52 · Reduced service | $23.99 | $32.36 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $9.77 Typical High $11.22 | Professional | 55 · Aftercare only | $7.24 | $9.77 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $6.61 Typical High $7.41 | Professional | 56 · Pre-op care only | $4.79 | $6.61 | $7.41 |
BCBS Massachusetts Setting Facility Modifier 52 · Reduced service Typical Low $22.39 Median $23.44 Typical High $51.29 | Facility | 52 · Reduced service | $22.39 | $23.44 | $51.29 |
BCBS Massachusetts Setting Professional Modifier 93 · Audio-only telehealth Typical Low $87.10 Median $134.90 Typical High $177.83 | Professional | 93 · Audio-only telehealth | $87.10 | $134.90 | $177.83 |
BCBS Massachusetts Setting Professional Modifier FQ · Audio-only Typical Low $63.10 Median $74.13 Typical High $102.33 | Professional | FQ · Audio-only | $63.10 | $74.13 | $102.33 |
Fallon Health Setting Facility Modifier SA · Nurse practitioner Typical Low $60.26 Median $79.43 Typical High $109.65 | Facility | SA · Nurse practitioner | $60.26 | $79.43 | $109.65 |
Fallon Health Setting Facility Modifier TD · Registered nurse Typical Low $72.44 Median $72.44 Typical High $79.43 | Facility | TD · Registered nurse | $72.44 | $72.44 | $79.43 |
Fallon Health Setting Facility Modifier U6 · State-defined Typical Low $67.61 Median $91.20 Typical High $125.89 | Facility | U6 · State-defined | $67.61 | $91.20 | $125.89 |
Fallon Health Setting Facility Modifier UG · Afternoon Typical Low $75.86 Median $75.86 Typical High $87.10 | Facility | UG · Afternoon | $75.86 | $75.86 | $87.10 |
Fallon Health Setting Professional Modifier SA · Nurse practitioner Typical Low $72.44 Median $77.62 Typical High $79.43 | Professional | SA · Nurse practitioner | $72.44 | $77.62 | $79.43 |
Fallon Health Setting Professional Modifier TD · Registered nurse Typical Low $72.44 Median $79.43 Typical High $79.43 | Professional | TD · Registered nurse | $72.44 | $79.43 | $79.43 |
Fallon Health Setting Professional Modifier U6 · State-defined Typical Low $85.11 Median $87.10 Typical High $93.33 | Professional | U6 · State-defined | $85.11 | $87.10 | $93.33 |
Fallon Health Setting Professional Modifier UG · Afternoon Typical Low $75.86 Median $75.86 Typical High $75.86 | Professional | UG · Afternoon | $75.86 | $75.86 | $75.86 |
Well Sense Setting Facility Modifier SA · Nurse practitioner Typical Low $60.26 Median $75.86 Typical High $141.25 | Facility | SA · Nurse practitioner | $60.26 | $75.86 | $141.25 |
Well Sense Setting Facility Modifier U4 · State-defined Typical Low $158.49 Median $223.87 Typical High $389.05 | Facility | U4 · State-defined | $158.49 | $223.87 | $389.05 |
Well Sense Setting Facility Modifier U6 · State-defined Typical Low $57.54 Median $81.28 Typical High $141.25 | Facility | U6 · State-defined | $57.54 | $81.28 | $141.25 |
Well Sense Setting Facility Modifier UG · Afternoon Typical Low $64.57 Median $91.20 Typical High $154.88 | Facility | UG · Afternoon | $64.57 | $91.20 | $154.88 |
Well Sense Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $37.15 Median $37.15 Typical High $44.67 | Professional | GF · Non-physician, rural hospital | $37.15 | $37.15 | $44.67 |
Well Sense Setting Professional Modifier U4 · State-defined Typical Low $186.21 Median $186.21 Typical High $223.87 | Professional | U4 · State-defined | $186.21 | $186.21 | $223.87 |
Where Massachusetts sits
The same service costs 2.2 times more in Alaska than in New Jersey. 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· 5th of 51
$89.13
AK $107NJ $48.98
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.