How much rates vary
Facilitymedian $158 · 10th to 90th $79 to $339Professionalmedian $209 · 10th to 90th $129 to $513
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 $125.89 Median $162.18 Typical High $239.88 | Facility | None | $125.89 | $162.18 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $125.89 Median $181.97 Typical High $288.40 | Professional | None | $125.89 | $181.97 | $288.40 |
AllWays Health Partners Setting Facility Modifier None Typical Low $120.23 Median $131.83 Typical High $389.05 | Facility | None | $120.23 | $131.83 | $389.05 |
AllWays Health Partners Setting Professional Modifier None Typical Low $141.25 Median $295.12 Typical High $1,047.13 | Professional | None | $141.25 | $295.12 | $1,047.13 |
AllWays Health Partners Setting Professional Modifier 25 · Same-day visit Typical Low $70.79 Median $138.04 Typical High $239.88 | Professional | 25 · Same-day visit | $70.79 | $138.04 | $239.88 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $128.82 Median $302.00 Typical High $407.38 | Facility | None | $128.82 | $302.00 | $407.38 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $128.82 Median $204.17 Typical High $346.74 | Professional | None | $128.82 | $204.17 | $346.74 |
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 $147.91 Median $190.55 Typical High $363.08 | Professional | None | $147.91 | $190.55 | $363.08 |
Fallon Health Setting Facility Modifier None Typical Low $70.79 Median $109.65 Typical High $190.55 | Facility | None | $70.79 | $109.65 | $190.55 |
Fallon Health Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $302.00 | Professional | None | $117.49 | $181.97 | $302.00 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $141.25 Median $263.03 Typical High $489.78 | Professional | None | $141.25 | $263.03 | $489.78 |
Health New England Setting Facility Modifier None Typical Low $177.83 Median $199.53 Typical High $501.19 | Facility | None | $177.83 | $199.53 | $501.19 |
Health New England Setting Professional Modifier None Typical Low $234.42 Median $416.87 Typical High $1,230.27 | Professional | None | $234.42 | $416.87 | $1,230.27 |
Mass General Brigham Setting Facility Modifier None Typical Low $120.23 Median $131.83 Typical High $389.05 | Facility | None | $120.23 | $131.83 | $389.05 |
Mass General Brigham Setting Professional Modifier None Typical Low $141.25 Median $295.12 Typical High $1,047.13 | Professional | None | $141.25 | $295.12 | $1,047.13 |
Mass General Brigham Setting Professional Modifier 25 · Same-day visit Typical Low $70.79 Median $138.04 Typical High $239.88 | Professional | 25 · Same-day visit | $70.79 | $138.04 | $239.88 |
Tufts Setting Facility Modifier None Typical Low $37.15 Median $102.33 Typical High $489.78 | Facility | None | $37.15 | $102.33 | $489.78 |
Tufts Setting Professional Modifier None Typical Low $102.33 Median $162.18 Typical High $316.23 | Professional | None | $102.33 | $162.18 | $316.23 |
United Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $446.68 | Professional | None | $128.82 | $199.53 | $446.68 |
Well Sense Setting Facility Modifier None Typical Low $109.65 Median $158.49 Typical High $251.19 | Facility | None | $109.65 | $158.49 | $251.19 |
Well Sense Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $104.71 | Professional | None | $87.10 | $87.10 | $104.71 |
21 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 $63.10 Median $77.62 Typical High $83.18 | Professional | 52 · Reduced service | $63.10 | $77.62 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.44 Typical High $24.55 | Professional | 55 · Aftercare only | $18.62 | $23.44 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $15.49 Typical High $16.60 | Professional | 56 · Pre-op care only | $12.59 | $15.49 | $16.60 |
BCBS Massachusetts Setting Professional Modifier 52 · Reduced service Typical Low $102.33 Median $151.36 Typical High $229.09 | Professional | 52 · Reduced service | $102.33 | $151.36 | $229.09 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $69.18 Typical High $134.90 | Professional | 53 · Discontinued | $43.65 | $69.18 | $134.90 |
BCBS Massachusetts Setting Professional Modifier 80 · Assistant surgeon Typical Low $27.54 Median $39.81 Typical High $63.10 | Professional | 80 · Assistant surgeon | $27.54 | $39.81 | $63.10 |
BCBS Massachusetts Setting Professional Modifier AS · PA/NP assist Typical Low $32.36 Median $56.23 Typical High $74.13 | Professional | AS · PA/NP assist | $32.36 | $56.23 | $74.13 |
Fallon Health Setting Facility Modifier SA · Nurse practitioner Typical Low $131.83 Median $169.82 Typical High $234.42 | Facility | SA · Nurse practitioner | $131.83 | $169.82 | $234.42 |
Fallon Health Setting Facility Modifier TD · Registered nurse Typical Low $169.82 Median $169.82 Typical High $181.97 | Facility | TD · Registered nurse | $169.82 | $169.82 | $181.97 |
Fallon Health Setting Facility Modifier U6 · State-defined Typical Low $154.88 Median $199.53 Typical High $269.15 | Facility | U6 · State-defined | $154.88 | $199.53 | $269.15 |
Fallon Health Setting Facility Modifier UG · Afternoon Typical Low $162.18 Median $162.18 Typical High $190.55 | Facility | UG · Afternoon | $162.18 | $162.18 | $190.55 |
Fallon Health Setting Professional Modifier SA · Nurse practitioner Typical Low $169.82 Median $169.82 Typical High $181.97 | Professional | SA · Nurse practitioner | $169.82 | $169.82 | $181.97 |
Fallon Health Setting Professional Modifier TD · Registered nurse Typical Low $169.82 Median $181.97 Typical High $181.97 | Professional | TD · Registered nurse | $169.82 | $181.97 | $181.97 |
Fallon Health Setting Professional Modifier U6 · State-defined Typical Low $199.53 Median $199.53 Typical High $213.80 | Professional | U6 · State-defined | $199.53 | $199.53 | $213.80 |
Fallon Health Setting Professional Modifier UG · Afternoon Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | UG · Afternoon | $162.18 | $162.18 | $162.18 |
Well Sense Setting Facility Modifier SA · Nurse practitioner Typical Low $131.83 Median $165.96 Typical High $309.03 | Facility | SA · Nurse practitioner | $131.83 | $165.96 | $309.03 |
Well Sense Setting Facility Modifier U4 · State-defined Typical Low $218.78 Median $309.03 Typical High $524.81 | Facility | U4 · State-defined | $218.78 | $309.03 | $524.81 |
Well Sense Setting Facility Modifier U6 · State-defined Typical Low $131.83 Median $186.21 Typical High $316.23 | Facility | U6 · State-defined | $131.83 | $186.21 | $316.23 |
Well Sense Setting Facility Modifier UG · Afternoon Typical Low $138.04 Median $194.98 Typical High $338.84 | Facility | UG · Afternoon | $138.04 | $194.98 | $338.84 |
Well Sense Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | GF · Non-physician, rural hospital | $77.62 | $77.62 | $93.33 |
Well Sense Setting Professional Modifier U4 · State-defined Typical Low $257.04 Median $257.04 Typical High $309.03 | Professional | U4 · State-defined | $257.04 | $257.04 | $309.03 |
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· 10th of 51
$209
AK $263AL $115
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.