How much rates vary
Facilitymedian $63 · 10th to 90th $30 to $132Professionalmedian $58 · 10th to 90th $37 to $148
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 $37.15 Median $37.15 Typical High $83.18 | Facility | None | $37.15 | $37.15 | $83.18 |
Aetna Setting Professional Modifier None Typical Low $37.15 Median $53.70 Typical High $83.18 | Professional | None | $37.15 | $53.70 | $83.18 |
AllWays Health Partners Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $645.65 | Facility | None | $87.10 | $120.23 | $645.65 |
AllWays Health Partners Setting Professional Modifier None Typical Low $39.81 Median $112.20 Typical High $371.54 | Professional | None | $39.81 | $112.20 | $371.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $89.13 Median $102.33 Typical High $134.90 | Facility | None | $89.13 | $102.33 | $134.90 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $48.98 Median $48.98 Typical High $87.10 | Professional | None | $48.98 | $48.98 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $107.15 | Professional | None | $47.86 | $53.70 | $107.15 |
Fallon Health Setting Facility Modifier None Typical Low $27.54 Median $56.23 Typical High $72.44 | Facility | None | $27.54 | $56.23 | $72.44 |
Fallon Health Setting Professional Modifier None Typical Low $27.54 Median $48.98 Typical High $70.79 | Professional | None | $27.54 | $48.98 | $70.79 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $44.67 Median $91.20 Typical High $128.82 | Professional | None | $44.67 | $91.20 | $128.82 |
Health New England Setting Professional Modifier None Typical Low $60.26 Median $91.20 Typical High $102.33 | Professional | None | $60.26 | $91.20 | $102.33 |
Mass General Brigham Setting Facility Modifier None Typical Low $87.10 Median $120.23 Typical High $645.65 | Facility | None | $87.10 | $120.23 | $645.65 |
Mass General Brigham Setting Professional Modifier None Typical Low $39.81 Median $112.20 Typical High $371.54 | Professional | None | $39.81 | $112.20 | $371.54 |
Tufts Setting Professional Modifier None Typical Low $30.90 Median $45.71 Typical High $74.13 | Professional | None | $30.90 | $45.71 | $74.13 |
United Setting Professional Modifier None Typical Low $39.81 Median $58.88 Typical High $138.04 | Professional | None | $39.81 | $58.88 | $138.04 |
Well Sense Setting Facility Modifier None Typical Low $45.71 Median $67.61 Typical High $117.49 | Facility | None | $45.71 | $67.61 | $117.49 |
Well Sense Setting Professional Modifier None Typical Low $28.18 Median $28.18 Typical High $33.88 | Professional | None | $28.18 | $28.18 | $33.88 |
10 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 $18.62 Median $18.62 Typical High $23.44 | Professional | 52 · Reduced service | $18.62 | $18.62 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $5.62 Typical High $7.08 | Professional | 55 · Aftercare only | $5.62 | $5.62 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.72 Median $3.72 Typical High $4.68 | Professional | 56 · Pre-op care only | $3.72 | $3.72 | $4.68 |
Fallon Health Setting Facility Modifier SA · Nurse practitioner Typical Low $47.86 Median $47.86 Typical High $52.48 | Facility | SA · Nurse practitioner | $47.86 | $47.86 | $52.48 |
Fallon Health Setting Facility Modifier TD · Registered nurse Typical Low $41.69 Median $41.69 Typical High $43.65 | Facility | TD · Registered nurse | $41.69 | $41.69 | $43.65 |
Fallon Health Setting Facility Modifier U6 · State-defined Typical Low $58.88 Median $58.88 Typical High $67.61 | Facility | U6 · State-defined | $58.88 | $58.88 | $67.61 |
Fallon Health Setting Facility Modifier UG · Afternoon Typical Low $77.62 Median $77.62 Typical High $85.11 | Facility | UG · Afternoon | $77.62 | $77.62 | $85.11 |
Well Sense Setting Facility Modifier SA · Nurse practitioner Typical Low $47.86 Median $63.10 Typical High $109.65 | Facility | SA · Nurse practitioner | $47.86 | $63.10 | $109.65 |
Well Sense Setting Facility Modifier U6 · State-defined Typical Low $58.88 Median $77.62 Typical High $138.04 | Facility | U6 · State-defined | $58.88 | $77.62 | $138.04 |
Well Sense Setting Facility Modifier UG · Afternoon Typical Low $77.62 Median $102.33 Typical High $181.97 | Facility | UG · Afternoon | $77.62 | $102.33 | $181.97 |
Where Massachusetts sits
The same service costs 2.7 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· 18th of 51
$58.88
AK $100NJ $37.15
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.