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Massachusetts rates for HCPCS 99281

Emergency department visit for the evaluation and management of a patient that may not require the presence of a physician or other qualified health care professional

Facilitymedian $17 · 10th–90th $6$2340%5%10%10th90th$17Professionalmedian $30 · 10th–90th $8$660%5%10%10th90th$30$5.0$20.0$100.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $234.42 / $537.03
Aetna
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$234.42 / $234.42 / $234.42
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $30.20 / $66.07
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$10.96 / $39.81 / $234.42
AllWays Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$125.89 / $144.54 / $147.91
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $489.78 / $489.78
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$13.49 / $22.39 / $46.77
Fallon Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.50 / $10.47 / $20.89
Fallon Health
Facility/Professional
Facility
Modifier
25
Typical Low / Median / Typical High
$12.02 / $12.02 / $24.55
Health New England
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $151.36 / $151.36
Mass General Brigham
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$177.83 / $177.83 / $177.83
Tufts
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.51 / $15.85 / $489.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $199.53 / $1,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$14.45 / $25.70 / $50.12
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$27.54 / $85.11 / $85.11