How much rates vary
Facilitymedian $100 · 10th to 90th $58 to $145Professionalmedian $155 · 10th to 90th $93 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 $93.33 Median $123.03 Typical High $154.88 | Facility | None | $93.33 | $123.03 | $154.88 |
Aetna Setting Professional Modifier None (both parts) Typical Low $93.33 Median $134.90 Typical High $181.97 | Professional | None (both parts) | $93.33 | $134.90 | $181.97 |
AllWays Health Partners Setting Facility Modifier None Typical Low $91.20 Median $93.33 Typical High $239.88 | Facility | None | $91.20 | $93.33 | $239.88 |
AllWays Health Partners Setting Professional Modifier None (both parts) Typical Low $104.71 Median $213.80 Typical High $741.31 | Professional | None (both parts) | $104.71 | $213.80 | $741.31 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $257.04 Median $257.04 Typical High $295.12 | Facility | None | $257.04 | $257.04 | $295.12 |
Cigna Setting Professional Modifier None (both parts) Typical Low $97.72 Median $128.82 Typical High $251.19 | Professional | None (both parts) | $97.72 | $128.82 | $251.19 |
Fallon Health Setting Facility Modifier None Typical Low $54.95 Median $97.72 Typical High $141.25 | Facility | None | $54.95 | $97.72 | $141.25 |
Fallon Health Setting Professional Modifier None (both parts) Typical Low $74.13 Median $125.89 Typical High $190.55 | Professional | None (both parts) | $74.13 | $125.89 | $190.55 |
Harvard Pilgrim Setting Professional Modifier None (both parts) Typical Low $104.71 Median $194.98 Typical High $309.03 | Professional | None (both parts) | $104.71 | $194.98 | $309.03 |
Mass General Brigham Setting Facility Modifier None Typical Low $91.20 Median $93.33 Typical High $239.88 | Facility | None | $91.20 | $93.33 | $239.88 |
Mass General Brigham Setting Professional Modifier None (both parts) Typical Low $104.71 Median $213.80 Typical High $741.31 | Professional | None (both parts) | $104.71 | $213.80 | $741.31 |
United Setting Professional Modifier None (both parts) Typical Low $104.71 Median $144.54 Typical High $302.00 | Professional | None (both parts) | $104.71 | $144.54 | $302.00 |
Well Sense Setting Facility Modifier None Typical Low $72.44 Median $104.71 Typical High $151.36 | Facility | None | $72.44 | $104.71 | $151.36 |
Well Sense Setting Professional Modifier None (both parts) Typical Low $64.57 Median $100.00 Typical High $120.23 | Professional | None (both parts) | $64.57 | $100.00 | $120.23 |
8 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 $46.77 Median $57.54 Typical High $69.18 | Professional | 52 · Reduced service | $46.77 | $57.54 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.13 Median $17.38 Typical High $20.89 | Professional | 55 · Aftercare only | $14.13 | $17.38 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $11.75 Typical High $13.80 | Professional | 56 · Pre-op care only | $9.33 | $11.75 | $13.80 |
AllWays Health Partners Setting Professional Modifier 26 · Professional part Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | 26 · Professional part | $141.25 | $141.25 | $147.91 |
Fallon Health Setting Professional Modifier HO · Master's level Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | HO · Master's level | $125.89 | $138.04 | $138.04 |
Fallon Health Setting Professional Modifier SA · Nurse practitioner Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | SA · Nurse practitioner | $125.89 | $138.04 | $138.04 |
Fallon Health Setting Professional Modifier U6 · State-defined Typical Low $125.89 Median $138.04 Typical High $138.04 | Professional | U6 · State-defined | $125.89 | $138.04 | $138.04 |
Mass General Brigham Setting Professional Modifier 26 · Professional part Typical Low $141.25 Median $141.25 Typical High $147.91 | Professional | 26 · Professional part | $141.25 | $141.25 | $147.91 |
Where Massachusetts sits
The same service costs 2.5 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
$155
AK $204AL $83.18
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.