How much rates vary
Facilitymedian $26 · 10th to 90th $13 to $56Professionalmedian $48 · 10th to 90th $25 to $112
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 $25.12 Median $38.90 Typical High $102.33 | Facility | None | $25.12 | $38.90 | $102.33 |
Aetna Setting Professional Modifier None Typical Low $25.12 Median $38.90 Typical High $58.88 | Professional | None | $25.12 | $38.90 | $58.88 |
AllWays Health Partners Setting Facility Modifier None Typical Low $20.89 Median $56.23 Typical High $75.86 | Facility | None | $20.89 | $56.23 | $75.86 |
AllWays Health Partners Setting Professional Modifier None Typical Low $28.84 Median $60.26 Typical High $245.47 | Professional | None | $28.84 | $60.26 | $245.47 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $22.91 Median $22.91 Typical High $53.70 | Facility | None | $22.91 | $22.91 | $53.70 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $22.91 Median $46.77 Typical High $79.43 | Professional | None | $22.91 | $46.77 | $79.43 |
Cigna Setting Professional Modifier None Typical Low $26.30 Median $44.67 Typical High $85.11 | Professional | None | $26.30 | $44.67 | $85.11 |
Fallon Health Setting Facility Modifier None Typical Low $12.88 Median $22.91 Typical High $33.88 | Facility | None | $12.88 | $22.91 | $33.88 |
Fallon Health Setting Professional Modifier None Typical Low $26.30 Median $45.71 Typical High $69.18 | Professional | None | $26.30 | $45.71 | $69.18 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $24.55 Median $53.70 Typical High $109.65 | Professional | None | $24.55 | $53.70 | $109.65 |
Health New England Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
Health New England Setting Professional Modifier None Typical Low $42.66 Median $67.61 Typical High $75.86 | Professional | None | $42.66 | $67.61 | $75.86 |
Mass General Brigham Setting Facility Modifier None Typical Low $20.89 Median $56.23 Typical High $75.86 | Facility | None | $20.89 | $56.23 | $75.86 |
Mass General Brigham Setting Professional Modifier None Typical Low $28.84 Median $60.26 Typical High $245.47 | Professional | None | $28.84 | $60.26 | $245.47 |
Tufts Setting Professional Modifier None Typical Low $29.51 Median $41.69 Typical High $75.86 | Professional | None | $29.51 | $41.69 | $75.86 |
United Setting Professional Modifier None Typical Low $26.30 Median $45.71 Typical High $107.15 | Professional | None | $26.30 | $45.71 | $107.15 |
Well Sense Setting Facility Modifier None Typical Low $20.89 Median $33.88 Typical High $47.86 | Facility | None | $20.89 | $33.88 | $47.86 |
Well Sense Setting Professional Modifier None Typical Low $18.20 Median $27.54 Typical High $33.11 | Professional | None | $18.20 | $27.54 | $33.11 |
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 $12.59 Median $17.78 Typical High $21.88 | Professional | 52 · Reduced service | $12.59 | $17.78 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.80 Median $5.37 Typical High $6.61 | Professional | 55 · Aftercare only | $3.80 | $5.37 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.51 Median $3.55 Typical High $4.37 | Professional | 56 · Pre-op care only | $2.51 | $3.55 | $4.37 |
BCBS Massachusetts Setting Professional Modifier 93 · Audio-only telehealth Typical Low $46.77 Median $77.62 Typical High $100.00 | Professional | 93 · Audio-only telehealth | $46.77 | $77.62 | $100.00 |
Fallon Health Setting Professional Modifier SA · Nurse practitioner Typical Low $44.67 Median $48.98 Typical High $48.98 | Professional | SA · Nurse practitioner | $44.67 | $48.98 | $48.98 |
Fallon Health Setting Professional Modifier U6 · State-defined Typical Low $44.67 Median $48.98 Typical High $48.98 | Professional | U6 · State-defined | $44.67 | $48.98 | $48.98 |
Well Sense Setting Facility Modifier EP · Child screening program Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | EP · Child screening program | $26.92 | $26.92 | $26.92 |
Well Sense Setting Professional Modifier 52 · Reduced service Typical Low $2.14 Median $2.14 Typical High $3.24 | Professional | 52 · Reduced service | $2.14 | $2.14 | $3.24 |
Well Sense Setting Professional Modifier HO · Master's level Typical Low $23.44 Median $27.54 Typical High $33.11 | Professional | HO · Master's level | $23.44 | $27.54 | $33.11 |
Well Sense Setting Professional Modifier SB · Nurse midwife Typical Low $22.91 Median $22.91 Typical High $32.36 | Professional | SB · Nurse midwife | $22.91 | $22.91 | $32.36 |
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· 6th of 51
$47.86
AK $66.07DC $23.99
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.