How much rates vary
Facilitymedian $102 · 10th to 90th $71 to $195Professionalmedian $151 · 10th to 90th $81 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 $85.11 Median $123.03 Typical High $281.84 | Facility | None | $85.11 | $123.03 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $123.03 Typical High $186.21 | Professional | None | $85.11 | $123.03 | $186.21 |
AllWays Health Partners Setting Facility Modifier None Typical Low $69.18 Median $173.78 Typical High $234.42 | Facility | None | $69.18 | $173.78 | $234.42 |
AllWays Health Partners Setting Professional Modifier None Typical Low $91.20 Median $190.55 Typical High $707.95 | Professional | None | $91.20 | $190.55 | $707.95 |
AllWays Health Partners Setting Professional Modifier 25 · Same-day visit Typical Low $43.65 Median $85.11 Typical High $162.18 | Professional | 25 · Same-day visit | $43.65 | $85.11 | $162.18 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $173.78 | Facility | None | $75.86 | $75.86 | $173.78 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $75.86 Median $138.04 Typical High $234.42 | Professional | None | $75.86 | $138.04 | $234.42 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $131.83 Typical High $251.19 | Professional | None | $87.10 | $131.83 | $251.19 |
Fallon Health Setting Facility Modifier None Typical Low $89.13 Median $109.65 Typical High $165.96 | Facility | None | $89.13 | $109.65 | $165.96 |
Fallon Health Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $194.98 | Professional | None | $158.49 | $165.96 | $194.98 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $81.28 Median $165.96 Typical High $323.59 | Professional | None | $81.28 | $165.96 | $323.59 |
Health New England Setting Professional Modifier None Typical Low $144.54 Median $204.17 Typical High $239.88 | Professional | None | $144.54 | $204.17 | $239.88 |
Mass General Brigham Setting Facility Modifier None Typical Low $69.18 Median $173.78 Typical High $234.42 | Facility | None | $69.18 | $173.78 | $234.42 |
Mass General Brigham Setting Professional Modifier None Typical Low $91.20 Median $190.55 Typical High $707.95 | Professional | None | $91.20 | $190.55 | $707.95 |
Mass General Brigham Setting Professional Modifier 25 · Same-day visit Typical Low $43.65 Median $85.11 Typical High $162.18 | Professional | 25 · Same-day visit | $43.65 | $85.11 | $162.18 |
United Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $316.23 | Professional | None | $81.28 | $134.90 | $316.23 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $87.10 Typical High $147.91 | Facility | None | $70.79 | $87.10 | $147.91 |
Well Sense Setting Professional Modifier None Typical Low $56.23 Median $87.10 Typical High $104.71 | Professional | None | $56.23 | $87.10 | $104.71 |
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 $41.69 Median $54.95 Typical High $63.10 | Professional | 52 · Reduced service | $41.69 | $54.95 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.60 Typical High $19.05 | Professional | 55 · Aftercare only | $12.59 | $16.60 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $11.22 Typical High $12.88 | Professional | 56 · Pre-op care only | $8.51 | $11.22 | $12.88 |
Well Sense Setting Facility Modifier U4 · State-defined Typical Low $83.18 Median $234.42 Typical High $436.52 | Facility | U4 · State-defined | $83.18 | $234.42 | $436.52 |
Well Sense Setting Professional Modifier 52 · Reduced service Typical Low $5.62 Median $5.62 Typical High $8.51 | Professional | 52 · Reduced service | $5.62 | $5.62 | $8.51 |
Well Sense Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $64.57 Median $64.57 Typical High $77.62 | Professional | GF · Non-physician, rural hospital | $64.57 | $64.57 | $77.62 |
Well Sense Setting Professional Modifier U4 · State-defined Typical Low $218.78 Median $218.78 Typical High $295.12 | Professional | U4 · State-defined | $218.78 | $218.78 | $295.12 |
Well Sense Setting Professional Modifier W6 Typical Low $74.13 Median $74.13 Typical High $89.13 | Professional | W6 | $74.13 | $74.13 | $89.13 |
Where Massachusetts sits
The same service costs 2.8 times more in Alaska than in Washington, DC. 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
$148
AK $219DC $77.62
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.