How much rates vary
Facilitymedian $107 · 10th to 90th $71 to $214Professionalmedian $151 · 10th to 90th $87 to $363
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 $89.13 Median $125.89 Typical High $281.84 | Facility | None | $89.13 | $125.89 | $281.84 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $125.89 Typical High $186.21 | Professional | None | $89.13 | $125.89 | $186.21 |
AllWays Health Partners Setting Facility Modifier None Typical Low $74.13 Median $186.21 Typical High $251.19 | Facility | None | $74.13 | $186.21 | $251.19 |
AllWays Health Partners Setting Professional Modifier None Typical Low $95.50 Median $194.98 Typical High $741.31 | Professional | None | $95.50 | $194.98 | $741.31 |
AllWays Health Partners Setting Professional Modifier 25 · Same-day visit Typical Low $46.77 Median $89.13 Typical High $169.82 | Professional | 25 · Same-day visit | $46.77 | $89.13 | $169.82 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $186.21 | Facility | None | $79.43 | $79.43 | $186.21 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $79.43 Median $144.54 Typical High $251.19 | Professional | None | $79.43 | $144.54 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $138.04 Typical High $257.04 | Professional | None | $91.20 | $138.04 | $257.04 |
Fallon Health Setting Facility Modifier None Typical Low $95.50 Median $117.49 Typical High $162.18 | Facility | None | $95.50 | $117.49 | $162.18 |
Fallon Health Setting Professional Modifier None Typical Low $165.96 Median $173.78 Typical High $204.17 | Professional | None | $165.96 | $173.78 | $204.17 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $87.10 Median $169.82 Typical High $331.13 | Professional | None | $87.10 | $169.82 | $331.13 |
Health New England Setting Professional Modifier None Typical Low $151.36 Median $181.97 Typical High $218.78 | Professional | None | $151.36 | $181.97 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $74.13 Median $186.21 Typical High $251.19 | Facility | None | $74.13 | $186.21 | $251.19 |
Mass General Brigham Setting Professional Modifier None Typical Low $95.50 Median $194.98 Typical High $741.31 | Professional | None | $95.50 | $194.98 | $741.31 |
Mass General Brigham Setting Professional Modifier 25 · Same-day visit Typical Low $46.77 Median $89.13 Typical High $169.82 | Professional | 25 · Same-day visit | $46.77 | $89.13 | $169.82 |
Tufts Setting Facility Modifier None Typical Low $37.15 Median $67.61 Typical High $407.38 | Facility | None | $37.15 | $67.61 | $407.38 |
Tufts Setting Professional Modifier None Typical Low $93.33 Median $128.82 Typical High $239.88 | Professional | None | $93.33 | $128.82 | $239.88 |
United Setting Professional Modifier None Typical Low $89.13 Median $141.25 Typical High $323.59 | Professional | None | $89.13 | $141.25 | $323.59 |
Well Sense Setting Facility Modifier None Typical Low $70.79 Median $93.33 Typical High $154.88 | Facility | None | $70.79 | $93.33 | $154.88 |
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 $44.67 Median $56.23 Typical High $63.10 | Professional | 52 · Reduced service | $44.67 | $56.23 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.49 Median $16.98 Typical High $19.05 | Professional | 55 · Aftercare only | $13.49 | $16.98 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.91 Median $11.48 Typical High $12.59 | Professional | 56 · Pre-op care only | $8.91 | $11.48 | $12.59 |
Well Sense Setting Facility Modifier U4 · State-defined Typical Low $87.10 Median $229.09 Typical High $436.52 | Facility | U4 · State-defined | $87.10 | $229.09 | $436.52 |
Well Sense Setting Professional Modifier 52 · Reduced service Typical Low $5.50 Median $5.50 Typical High $8.32 | Professional | 52 · Reduced service | $5.50 | $5.50 | $8.32 |
Well Sense Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $63.10 Median $63.10 Typical High $75.86 | Professional | GF · Non-physician, rural hospital | $63.10 | $63.10 | $75.86 |
Well Sense Setting Professional Modifier U4 · State-defined Typical Low $223.87 Median $223.87 Typical High $302.00 | Professional | U4 · State-defined | $223.87 | $223.87 | $302.00 |
Well Sense Setting Professional Modifier W6 Typical Low $72.44 Median $72.44 Typical High $87.10 | Professional | W6 | $72.44 | $72.44 | $87.10 |
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· 10th of 51
$148
AK $229DC $81.28
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.