How much rates vary
Facilitymedian $120 · 10th to 90th $76 to $245Professionalmedian $162 · 10th to 90th $98 to $380
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 $102.33 Median $138.04 Typical High $309.03 | Facility | None | $102.33 | $138.04 | $309.03 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $138.04 Typical High $208.93 | Professional | None | $102.33 | $138.04 | $208.93 |
AllWays Health Partners Setting Facility Modifier None Typical Low $83.18 Median $213.80 Typical High $281.84 | Facility | None | $83.18 | $213.80 | $281.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $104.71 Median $218.78 Typical High $812.83 | Professional | None | $104.71 | $218.78 | $812.83 |
AllWays Health Partners Setting Professional Modifier 25 · Same-day visit Typical Low $52.48 Median $100.00 Typical High $186.21 | Professional | 25 · Same-day visit | $52.48 | $100.00 | $186.21 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $204.17 | Facility | None | $91.20 | $91.20 | $204.17 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $91.20 Median $154.88 Typical High $269.15 | Professional | None | $91.20 | $154.88 | $269.15 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $151.36 Typical High $281.84 | Professional | None | $104.71 | $151.36 | $281.84 |
Fallon Health Setting Facility Modifier None Typical Low $107.15 Median $131.83 Typical High $181.97 | Facility | None | $107.15 | $131.83 | $181.97 |
Fallon Health Setting Professional Modifier None Typical Low $177.83 Median $186.21 Typical High $223.87 | Professional | None | $177.83 | $186.21 | $223.87 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $97.72 Median $194.98 Typical High $354.81 | Professional | None | $97.72 | $194.98 | $354.81 |
Health New England Setting Facility Modifier None Typical Low $79.43 Median $398.11 Typical High $426.58 | Facility | None | $79.43 | $398.11 | $426.58 |
Health New England Setting Professional Modifier None Typical Low $162.18 Median $204.17 Typical High $331.13 | Professional | None | $162.18 | $204.17 | $331.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $83.18 Median $213.80 Typical High $281.84 | Facility | None | $83.18 | $213.80 | $281.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $104.71 Median $218.78 Typical High $812.83 | Professional | None | $104.71 | $218.78 | $812.83 |
Mass General Brigham Setting Professional Modifier 25 · Same-day visit Typical Low $52.48 Median $100.00 Typical High $186.21 | Professional | 25 · Same-day visit | $52.48 | $100.00 | $186.21 |
Tufts Setting Facility Modifier None Typical Low $63.10 Median $75.86 Typical High $426.58 | Facility | None | $63.10 | $75.86 | $426.58 |
Tufts Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $251.19 | Professional | None | $83.18 | $128.82 | $251.19 |
United Setting Professional Modifier None Typical Low $102.33 Median $154.88 Typical High $346.74 | Professional | None | $102.33 | $154.88 | $346.74 |
Well Sense Setting Facility Modifier None Typical Low $64.57 Median $102.33 Typical High $177.83 | Facility | None | $64.57 | $102.33 | $177.83 |
Well Sense Setting Professional Modifier None Typical Low $63.10 Median $93.33 Typical High $112.20 | Professional | None | $63.10 | $93.33 | $112.20 |
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 $50.12 Median $60.26 Typical High $69.18 | Professional | 52 · Reduced service | $50.12 | $60.26 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $18.20 Typical High $20.89 | Professional | 55 · Aftercare only | $15.14 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $12.02 Typical High $13.80 | Professional | 56 · Pre-op care only | $10.00 | $12.02 | $13.80 |
Well Sense Setting Facility Modifier U4 · State-defined Typical Low $100.00 Median $245.47 Typical High $457.09 | Facility | U4 · State-defined | $100.00 | $245.47 | $457.09 |
Well Sense Setting Professional Modifier 52 · Reduced service Typical Low $5.89 Median $5.89 Typical High $8.91 | Professional | 52 · Reduced service | $5.89 | $5.89 | $8.91 |
Well Sense Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $69.18 Median $69.18 Typical High $83.18 | Professional | GF · Non-physician, rural hospital | $69.18 | $69.18 | $83.18 |
Well Sense Setting Professional Modifier U4 · State-defined Typical Low $229.09 Median $229.09 Typical High $309.03 | Professional | U4 · State-defined | $229.09 | $229.09 | $309.03 |
Well Sense Setting Professional Modifier W6 Typical Low $77.62 Median $77.62 Typical High $93.33 | Professional | W6 | $77.62 | $77.62 | $93.33 |
Where Massachusetts sits
The same service costs 2.7 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
$162
AK $251DC $93.33
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.