How much rates vary
Facilitymedian $151 · 10th to 90th $87 to $219Professionalmedian $229 · 10th to 90th $148 to $501
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 $147.91 Median $181.97 Typical High $229.09 | Facility | None | $147.91 | $181.97 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $147.91 Median $199.53 Typical High $269.15 | Professional | None | $147.91 | $199.53 | $269.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $91.20 Median $141.25 Typical High $371.54 | Facility | None | $91.20 | $141.25 | $371.54 |
AllWays Health Partners Setting Professional Modifier None Typical Low $154.88 Median $316.23 Typical High $1,122.02 | Professional | None | $154.88 | $316.23 | $1,122.02 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $389.05 Median $389.05 Typical High $457.09 | Facility | None | $389.05 | $389.05 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $181.97 Typical High $354.81 | Professional | None | $147.91 | $181.97 | $354.81 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $151.36 Typical High $218.78 | Facility | None | $83.18 | $151.36 | $218.78 |
Fallon Health Setting Professional Modifier None Typical Low $104.71 Median $181.97 Typical High $269.15 | Professional | None | $104.71 | $181.97 | $269.15 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $158.49 Median $302.00 Typical High $446.68 | Professional | None | $158.49 | $302.00 | $446.68 |
Mass General Brigham Setting Facility Modifier None Typical Low $91.20 Median $141.25 Typical High $371.54 | Facility | None | $91.20 | $141.25 | $371.54 |
Mass General Brigham Setting Professional Modifier None Typical Low $154.88 Median $316.23 Typical High $1,122.02 | Professional | None | $154.88 | $316.23 | $1,122.02 |
United Setting Professional Modifier None Typical Low $158.49 Median $218.78 Typical High $446.68 | Professional | None | $158.49 | $218.78 | $446.68 |
Well Sense Setting Facility Modifier None Typical Low $109.65 Median $151.36 Typical High $234.42 | Facility | None | $109.65 | $151.36 | $234.42 |
Well Sense Setting Professional Modifier None Typical Low $100.00 Median $147.91 Typical High $177.83 | Professional | None | $100.00 | $147.91 | $177.83 |
6 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 $74.13 Median $89.13 Typical High $102.33 | Professional | 52 · Reduced service | $74.13 | $89.13 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $26.92 Typical High $30.90 | Professional | 55 · Aftercare only | $22.39 | $26.92 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $14.79 Median $18.20 Typical High $20.42 | Professional | 56 · Pre-op care only | $14.79 | $18.20 | $20.42 |
Fallon Health Setting Professional Modifier HO · Master's level Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | HO · Master's level | $181.97 | $194.98 | $194.98 |
Fallon Health Setting Professional Modifier SA · Nurse practitioner Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | SA · Nurse practitioner | $181.97 | $194.98 | $194.98 |
Fallon Health Setting Professional Modifier U6 · State-defined Typical Low $181.97 Median $194.98 Typical High $194.98 | Professional | U6 · State-defined | $181.97 | $194.98 | $194.98 |
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· 4th of 51
$229
AK $288AL $123
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.