How much rates vary
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 $85.11 Median $102.33 Typical High $309.03 | Facility | None | $85.11 | $102.33 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $100.00 Typical High $107.15 | Professional | None | $85.11 | $100.00 | $107.15 |
AllWays Health Partners Setting Facility Modifier None Typical Low $63.10 Median $190.55 Typical High $245.47 | Facility | None | $63.10 | $190.55 | $245.47 |
AllWays Health Partners Setting Professional Modifier None Typical Low $97.72 Median $204.17 Typical High $741.31 | Professional | None | $97.72 | $204.17 | $741.31 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $186.21 | Facility | None | $81.28 | $81.28 | $186.21 |
Cigna Setting Professional Modifier None Typical Low $93.33 Median $117.49 Typical High $223.87 | Professional | None | $93.33 | $117.49 | $223.87 |
Fallon Health Setting Facility Modifier None Typical Low $93.33 Median $109.65 Typical High $131.83 | Facility | None | $93.33 | $109.65 | $131.83 |
Fallon Health Setting Professional Modifier None Typical Low $138.04 Median $158.49 Typical High $173.78 | Professional | None | $138.04 | $158.49 | $173.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $89.13 Median $177.83 Typical High $288.40 | Professional | None | $89.13 | $177.83 | $288.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $63.10 Median $190.55 Typical High $245.47 | Facility | None | $63.10 | $190.55 | $245.47 |
Mass General Brigham Setting Professional Modifier None Typical Low $97.72 Median $204.17 Typical High $741.31 | Professional | None | $97.72 | $204.17 | $741.31 |
United Setting Professional Modifier None Typical Low $97.72 Median $141.25 Typical High $281.84 | Professional | None | $97.72 | $141.25 | $281.84 |
Well Sense Setting Facility Modifier None Typical Low $74.13 Median $87.10 Typical High $144.54 | Facility | None | $74.13 | $87.10 | $144.54 |
Well Sense Setting Professional Modifier None Typical Low $72.44 Median $83.18 Typical High $100.00 | Professional | None | $72.44 | $83.18 | $100.00 |
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 $42.66 Median $50.12 Typical High $53.70 | Professional | 52 · Reduced service | $42.66 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $15.14 Typical High $15.85 | Professional | 55 · Aftercare only | $12.88 | $15.14 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.00 Typical High $10.72 | Professional | 56 · Pre-op care only | $8.51 | $10.00 | $10.72 |
Well Sense Setting Professional Modifier 52 · Reduced service Typical Low $7.08 Median $7.08 Typical High $10.72 | Professional | 52 · Reduced service | $7.08 | $7.08 | $10.72 |
Well Sense Setting Professional Modifier HO · Master's level Typical Low $77.62 Median $91.20 Typical High $109.65 | Professional | HO · Master's level | $77.62 | $91.20 | $109.65 |
Well Sense Setting Professional Modifier SB · Nurse midwife Typical Low $74.13 Median $74.13 Typical High $104.71 | Professional | SB · Nurse midwife | $74.13 | $74.13 | $104.71 |
Where Massachusetts sits
The same service costs 2.5 times more in Alaska than in Florida. 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· 6th of 51
$162
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.