How much rates vary
Facilitymedian $141 · 10th to 90th $87 to $288Professionalmedian $191 · 10th to 90th $117 to $437
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 $123.03 Median $162.18 Typical High $354.81 | Facility | None | $123.03 | $162.18 | $354.81 |
Aetna Setting Professional Modifier None Typical Low $123.03 Median $162.18 Typical High $245.47 | Professional | None | $123.03 | $162.18 | $245.47 |
AllWays Health Partners Setting Facility Modifier None Typical Low $102.33 Median $257.04 Typical High $346.74 | Facility | None | $102.33 | $257.04 | $346.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $954.99 | Professional | None | $123.03 | $257.04 | $954.99 |
AllWays Health Partners Setting Professional Modifier 25 · Same-day visit Typical Low $60.26 Median $120.23 Typical High $213.80 | Professional | 25 · Same-day visit | $60.26 | $120.23 | $213.80 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $251.19 | Facility | None | $109.65 | $109.65 | $251.19 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $109.65 Median $177.83 Typical High $309.03 | Professional | None | $109.65 | $177.83 | $309.03 |
Cigna Setting Professional Modifier None Typical Low $125.89 Median $173.78 Typical High $323.59 | Professional | None | $125.89 | $173.78 | $323.59 |
Fallon Health Setting Facility Modifier None Typical Low $131.83 Median $162.18 Typical High $213.80 | Facility | None | $131.83 | $162.18 | $213.80 |
Fallon Health Setting Professional Modifier None Typical Low $204.17 Median $218.78 Typical High $257.04 | Professional | None | $204.17 | $218.78 | $257.04 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $120.23 Median $234.42 Typical High $407.38 | Professional | None | $120.23 | $234.42 | $407.38 |
Health New England Setting Facility Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Facility | None | $79.43 | $79.43 | $79.43 |
Health New England Setting Professional Modifier None Typical Low $162.18 Median $275.42 Typical High $288.40 | Professional | None | $162.18 | $275.42 | $288.40 |
Mass General Brigham Setting Facility Modifier None Typical Low $102.33 Median $257.04 Typical High $346.74 | Facility | None | $102.33 | $257.04 | $346.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $123.03 Median $257.04 Typical High $954.99 | Professional | None | $123.03 | $257.04 | $954.99 |
Mass General Brigham Setting Professional Modifier 25 · Same-day visit Typical Low $60.26 Median $120.23 Typical High $213.80 | Professional | 25 · Same-day visit | $60.26 | $120.23 | $213.80 |
Tufts Setting Facility Modifier None Typical Low $37.15 Median $93.33 Typical High $407.38 | Facility | None | $37.15 | $93.33 | $407.38 |
Tufts Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $288.40 | Professional | None | $120.23 | $158.49 | $288.40 |
United Setting Professional Modifier None Typical Low $120.23 Median $181.97 Typical High $398.11 | Professional | None | $120.23 | $181.97 | $398.11 |
Well Sense Setting Facility Modifier None Typical Low $64.57 Median $120.23 Typical High $213.80 | Facility | None | $64.57 | $120.23 | $213.80 |
Well Sense Setting Professional Modifier None Typical Low $77.62 Median $109.65 Typical High $131.83 | Professional | None | $77.62 | $109.65 | $131.83 |
10 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 $61.66 Median $70.79 Typical High $79.43 | Professional | 52 · Reduced service | $61.66 | $70.79 | $79.43 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $21.38 Typical High $23.99 | Professional | 55 · Aftercare only | $18.62 | $21.38 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $14.45 Typical High $16.22 | Professional | 56 · Pre-op care only | $12.30 | $14.45 | $16.22 |
BCBS Massachusetts Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $75.86 Typical High $102.33 | Professional | 53 · Discontinued | $44.67 | $75.86 | $102.33 |
Well Sense Setting Facility Modifier U4 · State-defined Typical Low $120.23 Median $263.03 Typical High $489.78 | Facility | U4 · State-defined | $120.23 | $263.03 | $489.78 |
Well Sense Setting Professional Modifier 52 · Reduced service Typical Low $6.92 Median $6.92 Typical High $10.47 | Professional | 52 · Reduced service | $6.92 | $6.92 | $10.47 |
Well Sense Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $81.28 Median $81.28 Typical High $97.72 | Professional | GF · Non-physician, rural hospital | $81.28 | $81.28 | $97.72 |
Well Sense Setting Professional Modifier HO · Master's level Typical Low $74.13 Median $74.13 Typical High $100.00 | Professional | HO · Master's level | $74.13 | $74.13 | $100.00 |
Well Sense Setting Professional Modifier U4 · State-defined Typical Low $245.47 Median $245.47 Typical High $331.13 | Professional | U4 · State-defined | $245.47 | $245.47 | $331.13 |
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· 13th of 51
$186
AK $295DC $110
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.