How much rates vary
Facilitymedian $76 · 10th to 90th $41 to $132Professionalmedian $115 · 10th to 90th $69 to $251
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 $77.62 Median $89.13 Typical High $239.88 | Facility | None | $77.62 | $89.13 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $89.13 Typical High $125.89 | Professional | None | $77.62 | $89.13 | $125.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $63.10 Median $158.49 Typical High $213.80 | Facility | None | $63.10 | $158.49 | $213.80 |
AllWays Health Partners Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $549.54 | Professional | None | $79.43 | $162.18 | $549.54 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $154.88 | Facility | None | $69.18 | $69.18 | $154.88 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $173.78 | Professional | None | $69.18 | $100.00 | $173.78 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $97.72 Typical High $186.21 | Professional | None | $79.43 | $97.72 | $186.21 |
Fallon Health Setting Facility Modifier None Typical Low $38.90 Median $67.61 Typical High $100.00 | Facility | None | $38.90 | $67.61 | $100.00 |
Fallon Health Setting Professional Modifier None Typical Low $57.54 Median $100.00 Typical High $147.91 | Professional | None | $57.54 | $100.00 | $147.91 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $74.13 Median $147.91 Typical High $239.88 | Professional | None | $74.13 | $147.91 | $239.88 |
Health New England Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $138.04 | Professional | None | $75.86 | $95.50 | $138.04 |
Mass General Brigham Setting Facility Modifier None Typical Low $63.10 Median $158.49 Typical High $213.80 | Facility | None | $63.10 | $158.49 | $213.80 |
Mass General Brigham Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $549.54 | Professional | None | $79.43 | $162.18 | $549.54 |
United Setting Professional Modifier None Typical Low $77.62 Median $114.82 Typical High $234.42 | Professional | None | $77.62 | $114.82 | $234.42 |
Well Sense Setting Facility Modifier None Typical Low $58.88 Median $79.43 Typical High $123.03 | Facility | None | $58.88 | $79.43 | $123.03 |
Well Sense Setting Professional Modifier None Typical Low $54.95 Median $64.57 Typical High $77.62 | Professional | None | $54.95 | $64.57 | $77.62 |
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 $38.90 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $38.90 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $13.49 Typical High $15.85 | Professional | 55 · Aftercare only | $11.48 | $13.49 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $7.76 | $8.91 | $10.47 |
Fallon Health Setting Professional Modifier SA · Nurse practitioner Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | SA · Nurse practitioner | $100.00 | $107.15 | $107.15 |
Fallon Health Setting Professional Modifier U6 · State-defined Typical Low $100.00 Median $107.15 Typical High $107.15 | Professional | U6 · State-defined | $100.00 | $107.15 | $107.15 |
Well Sense Setting Facility Modifier EP · Child screening program Typical Low $70.79 Median $70.79 Typical High $70.79 | Facility | EP · Child screening program | $70.79 | $70.79 | $70.79 |
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 HO · Master's level Typical Low $53.70 Median $63.10 Typical High $75.86 | Professional | HO · Master's level | $53.70 | $63.10 | $75.86 |
Well Sense Setting Professional Modifier SB · Nurse midwife Typical Low $51.29 Median $51.29 Typical High $72.44 | Professional | SB · Nurse midwife | $51.29 | $51.29 | $72.44 |
Where Massachusetts sits
The same service costs 2.9 times more in Alaska than in Florida. 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
$115
AK $186FL $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.