How much rates vary
Facilitymedian $95 · 10th to 90th $65 to $170Professionalmedian $123 · 10th to 90th $68 to $302
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 $72.44 Median $104.71 Typical High $218.78 | Facility | None | $72.44 | $104.71 | $218.78 |
Aetna Setting Professional Modifier None Typical Low $72.44 Median $104.71 Typical High $144.54 | Professional | None | $72.44 | $104.71 | $144.54 |
AllWays Health Partners Setting Facility Modifier None Typical Low $58.88 Median $151.36 Typical High $204.17 | Facility | None | $58.88 | $151.36 | $204.17 |
AllWays Health Partners Setting Professional Modifier None Typical Low $75.86 Median $162.18 Typical High $616.60 | Professional | None | $75.86 | $162.18 | $616.60 |
AllWays Health Partners Setting Professional Modifier 25 · Same-day visit Typical Low $38.02 Median $72.44 Typical High $141.25 | Professional | 25 · Same-day visit | $38.02 | $72.44 | $141.25 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $151.36 | Facility | None | $64.57 | $64.57 | $151.36 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $64.57 Median $120.23 Typical High $204.17 | Professional | None | $64.57 | $120.23 | $204.17 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $114.82 Typical High $213.80 | Professional | None | $74.13 | $114.82 | $213.80 |
Fallon Health Setting Facility Modifier None Typical Low $74.13 Median $95.50 Typical High $120.23 | Facility | None | $74.13 | $95.50 | $120.23 |
Fallon Health Setting Professional Modifier None Typical Low $134.90 Median $144.54 Typical High $169.82 | Professional | None | $134.90 | $144.54 | $169.82 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $70.79 Median $141.25 Typical High $281.84 | Professional | None | $70.79 | $141.25 | $281.84 |
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 $95.50 Median $154.88 Typical High $181.97 | Professional | None | $95.50 | $154.88 | $181.97 |
Mass General Brigham Setting Facility Modifier None Typical Low $58.88 Median $151.36 Typical High $204.17 | Facility | None | $58.88 | $151.36 | $204.17 |
Mass General Brigham Setting Professional Modifier None Typical Low $75.86 Median $162.18 Typical High $616.60 | Professional | None | $75.86 | $162.18 | $616.60 |
Mass General Brigham Setting Professional Modifier 25 · Same-day visit Typical Low $38.02 Median $72.44 Typical High $141.25 | Professional | 25 · Same-day visit | $38.02 | $72.44 | $141.25 |
Tufts Setting Facility Modifier None Typical Low $37.15 Median $54.95 Typical High $407.38 | Facility | None | $37.15 | $54.95 | $407.38 |
Tufts Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $144.54 | Professional | None | $52.48 | $77.62 | $144.54 |
United Setting Professional Modifier None Typical Low $66.07 Median $112.20 Typical High $269.15 | Professional | None | $66.07 | $112.20 | $269.15 |
Well Sense Setting Facility Modifier None Typical Low $66.07 Median $97.72 Typical High $125.89 | Facility | None | $66.07 | $97.72 | $125.89 |
Well Sense Setting Professional Modifier None Typical Low $41.69 Median $63.10 Typical High $75.86 | Professional | None | $41.69 | $63.10 | $75.86 |
9 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 $36.31 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $36.31 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $13.49 Typical High $15.85 | Professional | 55 · Aftercare only | $10.72 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.24 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.24 | $9.12 | $10.47 |
Well Sense Setting Facility Modifier U4 · State-defined Typical Low $70.79 Median $218.78 Typical High $407.38 | Facility | U4 · State-defined | $70.79 | $218.78 | $407.38 |
Well Sense Setting Professional Modifier 52 · Reduced service Typical Low $3.98 Median $3.98 Typical High $5.89 | Professional | 52 · Reduced service | $3.98 | $3.98 | $5.89 |
Well Sense Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $45.71 Median $45.71 Typical High $54.95 | Professional | GF · Non-physician, rural hospital | $45.71 | $45.71 | $54.95 |
Well Sense Setting Professional Modifier U4 · State-defined Typical Low $204.17 Median $204.17 Typical High $275.42 | Professional | U4 · State-defined | $204.17 | $204.17 | $275.42 |
Well Sense Setting Professional Modifier W5 Typical Low $48.98 Median $48.98 Typical High $57.54 | Professional | W5 | $48.98 | $48.98 | $57.54 |
Well Sense Setting Professional Modifier W7 Typical Low $54.95 Median $54.95 Typical High $66.07 | Professional | W7 | $54.95 | $54.95 | $66.07 |
Where Massachusetts sits
The same service costs 2.9 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· 8th of 51
$123
AK $186DC $64.57
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.