How much rates vary
Facilitymedian $50 · 10th to 90th $32 to $2,188Professionalmedian $1,259 · 10th to 90th $33 to $4,169
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 $1,096.48 Median $1,230.27 Typical High $1,445.44 | Facility | None | $1,096.48 | $1,230.27 | $1,445.44 |
Aetna Setting Professional Modifier None Typical Low $933.25 Median $1,230.27 Typical High $1,445.44 | Professional | None | $933.25 | $1,230.27 | $1,445.44 |
AllWays Health Partners Setting Facility Modifier None Typical Low $31.62 Median $79.43 Typical High $3,715.35 | Facility | None | $31.62 | $79.43 | $3,715.35 |
AllWays Health Partners Setting Professional Modifier None Typical Low $31.62 Median $1,380.38 Typical High $7,244.36 | Professional | None | $31.62 | $1,380.38 | $7,244.36 |
AllWays Health Partners Setting Professional Modifier 25 · Same-day visit Typical Low $16.22 Median $107.15 Typical High $2,137.96 | Professional | 25 · Same-day visit | $16.22 | $107.15 | $2,137.96 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $33.88 Median $1,513.56 Typical High $2,137.96 | Facility | None | $33.88 | $1,513.56 | $2,137.96 |
BCBS Massachusetts Setting Professional Modifier None Typical Low $33.88 Median $1,659.59 Typical High $2,884.03 | Professional | None | $33.88 | $1,659.59 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
Fallon Health Setting Facility Modifier None Typical Low $34.67 Median $42.66 Typical High $58.88 | Facility | None | $34.67 | $42.66 | $58.88 |
Fallon Health Setting Professional Modifier None Typical Low $1,778.28 Median $2,187.76 Typical High $2,951.21 | Professional | None | $1,778.28 | $2,187.76 | $2,951.21 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $33.88 Median $851.14 Typical High $3,715.35 | Professional | None | $33.88 | $851.14 | $3,715.35 |
Mass General Brigham Setting Facility Modifier None Typical Low $31.62 Median $79.43 Typical High $3,715.35 | Facility | None | $31.62 | $79.43 | $3,715.35 |
Mass General Brigham Setting Professional Modifier None Typical Low $31.62 Median $1,380.38 Typical High $7,244.36 | Professional | None | $31.62 | $1,380.38 | $7,244.36 |
Mass General Brigham Setting Professional Modifier 25 · Same-day visit Typical Low $16.22 Median $107.15 Typical High $2,137.96 | Professional | 25 · Same-day visit | $16.22 | $107.15 | $2,137.96 |
Tufts Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $2,511.89 | Professional | None | $954.99 | $954.99 | $2,511.89 |
United Setting Facility Modifier None Typical Low $2,238.72 Median $4,265.80 Typical High $6,309.57 | Facility | None | $2,238.72 | $4,265.80 | $6,309.57 |
United Setting Professional Modifier None Typical Low $27.54 Median $831.76 Typical High $3,548.13 | Professional | None | $27.54 | $831.76 | $3,548.13 |
Well Sense Setting Facility Modifier None Typical Low $23.44 Median $912.01 Typical High $1,905.46 | Facility | None | $23.44 | $912.01 | $1,905.46 |
Well Sense Setting Professional Modifier None Typical Low $19.50 Median $933.25 Typical High $1,122.02 | Professional | None | $19.50 | $933.25 | $1,122.02 |
8 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 $575.44 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $575.44 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $234.42 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $177.83 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $120.23 | $144.54 | $144.54 |
Fallon Health Setting Facility Modifier TD · Registered nurse Typical Low $1,348.96 Median $1,348.96 Typical High $1,513.56 | Facility | TD · Registered nurse | $1,348.96 | $1,348.96 | $1,513.56 |
Fallon Health Setting Professional Modifier SA · Nurse practitioner Typical Low $1,348.96 Median $1,513.56 Typical High $1,513.56 | Professional | SA · Nurse practitioner | $1,348.96 | $1,513.56 | $1,513.56 |
Fallon Health Setting Professional Modifier TD · Registered nurse Typical Low $1,348.96 Median $1,348.96 Typical High $1,513.56 | Professional | TD · Registered nurse | $1,348.96 | $1,348.96 | $1,513.56 |
Fallon Health Setting Professional Modifier U6 · State-defined Typical Low $1,584.89 Median $1,659.59 Typical High $1,778.28 | Professional | U6 · State-defined | $1,584.89 | $1,659.59 | $1,778.28 |
Where Massachusetts sits
The same service costs 49.0 times more in Hawaii than in Maryland. 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· 3rd of 51
$1,259
HI $1,622MD $33.11
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.