How much rates vary
Facilitymedian $100 · 10th to 90th $49 to $224Professionalmedian $98 · 10th to 90th $63 to $229
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 $69.18 Median $85.11 Typical High $104.71 | Facility | None | $69.18 | $85.11 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $89.13 Typical High $125.89 | Professional | None | $69.18 | $89.13 | $125.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $87.10 Median $190.55 Typical High $645.65 | Facility | None | $87.10 | $190.55 | $645.65 |
AllWays Health Partners Setting Professional Modifier None Typical Low $66.07 Median $181.97 Typical High $457.09 | Professional | None | $66.07 | $181.97 | $457.09 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $162.18 Median $190.55 Typical High $251.19 | Facility | None | $162.18 | $190.55 | $251.19 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $165.96 | Professional | None | $77.62 | $77.62 | $165.96 |
Cigna Setting Professional Modifier None Typical Low $81.28 Median $87.10 Typical High $173.78 | Professional | None | $81.28 | $87.10 | $173.78 |
Fallon Health Setting Facility Modifier None Typical Low $44.67 Median $85.11 Typical High $114.82 | Facility | None | $44.67 | $85.11 | $114.82 |
Fallon Health Setting Professional Modifier None Typical Low $43.65 Median $79.43 Typical High $114.82 | Professional | None | $43.65 | $79.43 | $114.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $213.80 | Professional | None | $79.43 | $147.91 | $213.80 |
Health New England Setting Facility Modifier None Typical Low $851.14 Median $1,621.81 Typical High $1,698.24 | Facility | None | $851.14 | $1,621.81 | $1,698.24 |
Health New England Setting Professional Modifier None Typical Low $91.20 Median $162.18 Typical High $169.82 | Professional | None | $91.20 | $162.18 | $169.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $87.10 Median $190.55 Typical High $645.65 | Facility | None | $87.10 | $190.55 | $645.65 |
Mass General Brigham Setting Professional Modifier None Typical Low $66.07 Median $181.97 Typical High $457.09 | Professional | None | $66.07 | $181.97 | $457.09 |
Tufts Setting Professional Modifier None Typical Low $51.29 Median $72.44 Typical High $125.89 | Professional | None | $51.29 | $72.44 | $125.89 |
United Setting Professional Modifier None Typical Low $67.61 Median $107.15 Typical High $229.09 | Professional | None | $67.61 | $107.15 | $229.09 |
Well Sense Setting Facility Modifier None Typical Low $72.44 Median $102.33 Typical High $173.78 | Facility | None | $72.44 | $102.33 | $173.78 |
Well Sense Setting Professional Modifier None Typical Low $51.29 Median $51.29 Typical High $61.66 | Professional | None | $51.29 | $51.29 | $61.66 |
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 $34.67 Median $34.67 Typical High $37.15 | Professional | 52 · Reduced service | $34.67 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $10.47 Typical High $11.22 | Professional | 55 · Aftercare only | $10.47 | $10.47 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $6.92 Typical High $7.41 | Professional | 56 · Pre-op care only | $6.92 | $6.92 | $7.41 |
Fallon Health Setting Facility Modifier SA · Nurse practitioner Typical Low $70.79 Median $70.79 Typical High $89.13 | Facility | SA · Nurse practitioner | $70.79 | $70.79 | $89.13 |
Fallon Health Setting Facility Modifier TD · Registered nurse Typical Low $66.07 Median $66.07 Typical High $69.18 | Facility | TD · Registered nurse | $66.07 | $66.07 | $69.18 |
Fallon Health Setting Facility Modifier U6 · State-defined Typical Low $89.13 Median $89.13 Typical High $117.49 | Facility | U6 · State-defined | $89.13 | $89.13 | $117.49 |
Fallon Health Setting Facility Modifier UG · Afternoon Typical Low $117.49 Median $117.49 Typical High $128.82 | Facility | UG · Afternoon | $117.49 | $117.49 | $128.82 |
Well Sense Setting Facility Modifier SA · Nurse practitioner Typical Low $70.79 Median $93.33 Typical High $165.96 | Facility | SA · Nurse practitioner | $70.79 | $93.33 | $165.96 |
Well Sense Setting Facility Modifier U6 · State-defined Typical Low $89.13 Median $114.82 Typical High $204.17 | Facility | U6 · State-defined | $89.13 | $114.82 | $204.17 |
Well Sense Setting Facility Modifier UG · Afternoon Typical Low $117.49 Median $151.36 Typical High $275.42 | Facility | UG · Afternoon | $117.49 | $151.36 | $275.42 |
Where Massachusetts sits
The same service costs 2.4 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· 15th of 51
$97.72
AK $155AL $64.57
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.