How much rates vary
Facilitymedian $107 · 10th to 90th $65 to $219Professionalmedian $148 · 10th to 90th $83 to $339
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 $93.33 Median $125.89 Typical High $263.03 | Facility | None | $93.33 | $125.89 | $263.03 |
Aetna Setting Professional Modifier None Typical Low $93.33 Median $125.89 Typical High $186.21 | Professional | None | $93.33 | $125.89 | $186.21 |
AllWays Health Partners Setting Facility Modifier None Typical Low $75.86 Median $190.55 Typical High $257.04 | Facility | None | $75.86 | $190.55 | $257.04 |
AllWays Health Partners Setting Professional Modifier None Typical Low $93.33 Median $204.17 Typical High $724.44 | Professional | None | $93.33 | $204.17 | $724.44 |
AllWays Health Partners Setting Professional Modifier 25 · Same-day visit Typical Low $46.77 Median $91.20 Typical High $165.96 | Professional | 25 · Same-day visit | $46.77 | $91.20 | $165.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $186.21 | Facility | None | $83.18 | $83.18 | $186.21 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $83.18 Median $141.25 Typical High $239.88 | Professional | None | $83.18 | $141.25 | $239.88 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $134.90 Typical High $251.19 | Professional | None | $95.50 | $134.90 | $251.19 |
Fallon Health Setting Facility Modifier None Typical Low $95.50 Median $120.23 Typical High $154.88 | Facility | None | $95.50 | $120.23 | $154.88 |
Fallon Health Setting Professional Modifier None Typical Low $162.18 Median $169.82 Typical High $199.53 | Professional | None | $162.18 | $169.82 | $199.53 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $89.13 Median $177.83 Typical High $331.13 | Professional | None | $89.13 | $177.83 | $331.13 |
Health New England Setting Facility Modifier None Typical Low $51.29 Median $83.18 Typical High $380.19 | Facility | None | $51.29 | $83.18 | $380.19 |
Health New England Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $218.78 | Professional | None | $117.49 | $181.97 | $218.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $75.86 Median $190.55 Typical High $257.04 | Facility | None | $75.86 | $190.55 | $257.04 |
Mass General Brigham Setting Professional Modifier None Typical Low $93.33 Median $204.17 Typical High $724.44 | Professional | None | $93.33 | $204.17 | $724.44 |
Mass General Brigham Setting Professional Modifier 25 · Same-day visit Typical Low $46.77 Median $91.20 Typical High $165.96 | Professional | 25 · Same-day visit | $46.77 | $91.20 | $165.96 |
Tufts Setting Facility Modifier None Typical Low $25.70 Median $66.07 Typical High $426.58 | Facility | None | $25.70 | $66.07 | $426.58 |
Tufts Setting Professional Modifier None Typical Low $72.44 Median $117.49 Typical High $223.87 | Professional | None | $72.44 | $117.49 | $223.87 |
United Setting Professional Modifier None Typical Low $85.11 Median $138.04 Typical High $323.59 | Professional | None | $85.11 | $138.04 | $323.59 |
Well Sense Setting Facility Modifier None Typical Low $64.57 Median $93.33 Typical High $162.18 | Facility | None | $64.57 | $93.33 | $162.18 |
Well Sense Setting Professional Modifier None Typical Low $56.23 Median $77.62 Typical High $93.33 | Professional | None | $56.23 | $77.62 | $93.33 |
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 $45.71 Median $53.70 Typical High $63.10 | Professional | 52 · Reduced service | $45.71 | $53.70 | $63.10 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $16.22 Typical High $18.62 | Professional | 55 · Aftercare only | $13.80 | $16.22 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.33 Median $10.96 Typical High $12.59 | Professional | 56 · Pre-op care only | $9.33 | $10.96 | $12.59 |
BCBS Massachusetts Setting Professional Modifier 78 · Unplanned return to OR Typical Low $112.20 Median $186.21 Typical High $239.88 | Professional | 78 · Unplanned return to OR | $112.20 | $186.21 | $239.88 |
Well Sense Setting Facility Modifier U4 · State-defined Typical Low $89.13 Median $234.42 Typical High $436.52 | Facility | U4 · State-defined | $89.13 | $234.42 | $436.52 |
Well Sense Setting Professional Modifier 52 · Reduced service Typical Low $4.79 Median $4.79 Typical High $7.24 | Professional | 52 · Reduced service | $4.79 | $4.79 | $7.24 |
Well Sense Setting Professional Modifier GF · Non-physician, rural hospital Typical Low $56.23 Median $56.23 Typical High $67.61 | Professional | GF · Non-physician, rural hospital | $56.23 | $56.23 | $67.61 |
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 W5 Typical Low $57.54 Median $57.54 Typical High $67.61 | Professional | W5 | $57.54 | $57.54 | $67.61 |
Well Sense Setting Professional Modifier W7 Typical Low $64.57 Median $64.57 Typical High $77.62 | Professional | W7 | $64.57 | $64.57 | $77.62 |
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· 12th of 51
$145
AK $224DC $83.18
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.