How much rates vary
Facilitymedian $200 · 10th to 90th $115 to $288Professionalmedian $275 · 10th to 90th $186 to $646
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 $186.21 Median $218.78 Typical High $275.42 | Facility | None | $186.21 | $218.78 | $275.42 |
Aetna Setting Professional Modifier None Typical Low $186.21 Median $245.47 Typical High $323.59 | Professional | None | $186.21 | $245.47 | $323.59 |
AllWays Health Partners Setting Facility Modifier None Typical Low $91.20 Median $190.55 Typical High $489.78 | Facility | None | $91.20 | $190.55 | $489.78 |
AllWays Health Partners Setting Professional Modifier None Typical Low $199.53 Median $407.38 Typical High $1,348.96 | Professional | None | $199.53 | $407.38 | $1,348.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $524.81 Median $524.81 Typical High $602.56 | Facility | None | $524.81 | $524.81 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $239.88 Typical High $457.09 | Professional | None | $199.53 | $239.88 | $457.09 |
Fallon Health Setting Facility Modifier None Typical Low $109.65 Median $199.53 Typical High $288.40 | Facility | None | $109.65 | $199.53 | $288.40 |
Fallon Health Setting Professional Modifier None Typical Low $134.90 Median $234.42 Typical High $354.81 | Professional | None | $134.90 | $234.42 | $354.81 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $213.80 Median $389.05 Typical High $588.84 | Professional | None | $213.80 | $389.05 | $588.84 |
Mass General Brigham Setting Facility Modifier None Typical Low $91.20 Median $190.55 Typical High $489.78 | Facility | None | $91.20 | $190.55 | $489.78 |
Mass General Brigham Setting Professional Modifier None Typical Low $199.53 Median $407.38 Typical High $1,348.96 | Professional | None | $199.53 | $407.38 | $1,348.96 |
United Setting Professional Modifier None Typical Low $194.98 Median $263.03 Typical High $575.44 | Professional | None | $194.98 | $263.03 | $575.44 |
Well Sense Setting Facility Modifier None Typical Low $147.91 Median $199.53 Typical High $309.03 | Facility | None | $147.91 | $199.53 | $309.03 |
Well Sense Setting Professional Modifier None Typical Low $131.83 Median $177.83 Typical High $213.80 | Professional | None | $131.83 | $177.83 | $213.80 |
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 $93.33 Median $109.65 Typical High $125.89 | Professional | 52 · Reduced service | $93.33 | $109.65 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $27.54 Median $33.11 Typical High $38.02 | Professional | 55 · Aftercare only | $27.54 | $33.11 | $38.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $21.88 Typical High $25.12 | Professional | 56 · Pre-op care only | $18.62 | $21.88 | $25.12 |
Fallon Health Setting Professional Modifier HO · Master's level Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | HO · Master's level | $234.42 | $251.19 | $251.19 |
Fallon Health Setting Professional Modifier SA · Nurse practitioner Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | SA · Nurse practitioner | $234.42 | $251.19 | $251.19 |
Fallon Health Setting Professional Modifier U6 · State-defined Typical Low $234.42 Median $251.19 Typical High $251.19 | Professional | U6 · State-defined | $234.42 | $251.19 | $251.19 |
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· 7th of 51
$275
AK $380AL $158
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.