How much rates vary
Facilitymedian $98 · 10th to 90th $49 to $209Professionalmedian $138 · 10th to 90th $78 to $347
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 $74.13 Median $107.15 Typical High $162.18 | Facility | None | $74.13 | $107.15 | $162.18 |
Aetna Setting Professional Modifier None Typical Low $74.13 Median $120.23 Typical High $181.97 | Professional | None | $74.13 | $120.23 | $181.97 |
AllWays Health Partners Setting Facility Modifier None Typical Low $72.44 Median $89.13 Typical High $234.42 | Facility | None | $72.44 | $89.13 | $234.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $85.11 Median $190.55 Typical High $691.83 | Professional | None | $85.11 | $190.55 | $691.83 |
AllWays Health Partners Setting Professional Modifier 25 · Same-day visit Typical Low $44.67 Median $87.10 Typical High $162.18 | Professional | 25 · Same-day visit | $44.67 | $87.10 | $162.18 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $77.62 Median $181.97 Typical High $245.47 | Facility | None | $77.62 | $181.97 | $245.47 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $77.62 Median $134.90 Typical High $229.09 | Professional | None | $77.62 | $134.90 | $229.09 |
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 $91.20 Median $128.82 Typical High $239.88 | Professional | None | $91.20 | $128.82 | $239.88 |
Fallon Health Setting Facility Modifier None Typical Low $43.65 Median $67.61 Typical High $114.82 | Facility | None | $43.65 | $67.61 | $114.82 |
Fallon Health Setting Professional Modifier None Typical Low $74.13 Median $117.49 Typical High $199.53 | Professional | None | $74.13 | $117.49 | $199.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $85.11 Median $165.96 Typical High $323.59 | Professional | None | $85.11 | $165.96 | $323.59 |
Health New England Setting Facility Modifier None Typical Low $97.72 Median $125.89 Typical High $338.84 | Facility | None | $97.72 | $125.89 | $338.84 |
Health New England Setting Professional Modifier None Typical Low $141.25 Median $218.78 Typical High $831.76 | Professional | None | $141.25 | $218.78 | $831.76 |
Mass General Brigham Setting Facility Modifier None Typical Low $72.44 Median $89.13 Typical High $234.42 | Facility | None | $72.44 | $89.13 | $234.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $85.11 Median $190.55 Typical High $691.83 | Professional | None | $85.11 | $190.55 | $691.83 |
Mass General Brigham Setting Professional Modifier 25 · Same-day visit Typical Low $44.67 Median $87.10 Typical High $162.18 | Professional | 25 · Same-day visit | $44.67 | $87.10 | $162.18 |
Tufts Setting Facility Modifier None Typical Low $37.15 Median $66.07 Typical High $489.78 | Facility | None | $37.15 | $66.07 | $489.78 |
Tufts Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $213.80 | Professional | None | $74.13 | $109.65 | $213.80 |
United Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $302.00 | Professional | None | $79.43 | $131.83 | $302.00 |
Well Sense Setting Facility Modifier None Typical Low $72.44 Median $104.71 Typical High $147.91 | Facility | None | $72.44 | $104.71 | $147.91 |
Well Sense Setting Professional Modifier None Typical Low $53.70 Median $53.70 Typical High $64.57 | Professional | None | $53.70 | $53.70 | $64.57 |
22 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 $37.15 Median $47.86 Typical High $53.70 | Professional | 52 · Reduced service | $37.15 | $47.86 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $14.45 Typical High $16.22 | Professional | 55 · Aftercare only | $10.96 | $14.45 | $16.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $9.55 Typical High $10.72 | Professional | 56 · Pre-op care only | $7.41 | $9.55 | $10.72 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $93.33 Typical High $199.53 | Professional | 52 · Reduced service | $57.54 | $93.33 | $199.53 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $35.48 Typical High $72.44 | Professional | 53 · Discontinued | $26.92 | $35.48 | $72.44 |
BCBS Massachusetts Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $30.20 Typical High $61.66 | Professional | 55 · Aftercare only | $18.62 | $30.20 | $61.66 |
BCBS Massachusetts Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $13.18 Typical High $17.78 | Professional | 56 · Pre-op care only | $7.76 | $13.18 | $17.78 |
BCBS Massachusetts Setting Professional Modifier AS · PA/NP assist Typical Low $31.62 Median $37.15 Typical High $57.54 | Professional | AS · PA/NP assist | $31.62 | $37.15 | $57.54 |
Fallon Health Setting Facility Modifier SA · Nurse practitioner Typical Low $89.13 Median $112.20 Typical High $151.36 | Facility | SA · Nurse practitioner | $89.13 | $112.20 | $151.36 |
Fallon Health Setting Facility Modifier TD · Registered nurse Typical Low $112.20 Median $112.20 Typical High $123.03 | Facility | TD · Registered nurse | $112.20 | $112.20 | $123.03 |
Fallon Health Setting Facility Modifier U6 · State-defined Typical Low $104.71 Median $134.90 Typical High $177.83 | Facility | U6 · State-defined | $104.71 | $134.90 | $177.83 |
Fallon Health Setting Facility Modifier UG · Afternoon Typical Low $109.65 Median $109.65 Typical High $125.89 | Facility | UG · Afternoon | $109.65 | $109.65 | $125.89 |
Fallon Health Setting Professional Modifier SA · Nurse practitioner Typical Low $112.20 Median $120.23 Typical High $123.03 | Professional | SA · Nurse practitioner | $112.20 | $120.23 | $123.03 |
Fallon Health Setting Professional Modifier TD · Registered nurse Typical Low $112.20 Median $123.03 Typical High $123.03 | Professional | TD · Registered nurse | $112.20 | $123.03 | $123.03 |
Fallon Health Setting Professional Modifier U6 · State-defined Typical Low $131.83 Median $131.83 Typical High $144.54 | Professional | U6 · State-defined | $131.83 | $131.83 | $144.54 |
Fallon Health Setting Professional Modifier UG · Afternoon Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | UG · Afternoon | $109.65 | $109.65 | $109.65 |
Well Sense Setting Facility Modifier SA · Nurse practitioner Typical Low $89.13 Median $109.65 Typical High $204.17 | Facility | SA · Nurse practitioner | $89.13 | $109.65 | $204.17 |
Well Sense Setting Facility Modifier U4 · State-defined Typical Low $181.97 Median $257.04 Typical High $436.52 | Facility | U4 · State-defined | $181.97 | $257.04 | $436.52 |
Well Sense Setting Facility Modifier U6 · State-defined Typical Low $87.10 Median $123.03 Typical High $213.80 | Facility | U6 · State-defined | $87.10 | $123.03 | $213.80 |
Well Sense Setting Facility Modifier UG · Afternoon Typical Low $93.33 Median $128.82 Typical High $223.87 | Facility | UG · Afternoon | $93.33 | $128.82 | $223.87 |
Well Sense Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | GF · Non-physician, rural hospital | $54.95 | $54.95 | $66.07 |
Well Sense Setting Professional Modifier U4 · State-defined Typical Low $213.80 Median $213.80 Typical High $257.04 | Professional | U4 · State-defined | $213.80 | $213.80 | $257.04 |
Where Massachusetts sits
The same service costs 2.3 times more in Alaska than in Alabama. 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
$138
AK $170AL $74.13
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.