How much rates vary
Facilitymedian $129 · 10th to 90th $95 to $331Professionalmedian $65 · 10th to 90th $48 to $132
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 $64.57 Median $64.57 Typical High $204.17 | Facility | None | $64.57 | $64.57 | $204.17 |
Aetna Setting Professional Modifier None Typical Low $64.57 Median $64.57 Typical High $67.61 | Professional | None | $64.57 | $64.57 | $67.61 |
AllWays Health Partners Setting Facility Modifier None Typical Low $97.72 Median $104.71 Typical High $338.84 | Facility | None | $97.72 | $104.71 | $338.84 |
AllWays Health Partners Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $660.69 | Professional | None | $51.29 | $85.11 | $660.69 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $114.82 Median $134.90 Typical High $177.83 | Facility | None | $114.82 | $134.90 | $177.83 |
Cigna Setting Professional Modifier None Typical Low $47.86 Median $47.86 Typical High $47.86 | Professional | None | $47.86 | $47.86 | $47.86 |
Fallon Health Setting Facility Modifier None Typical Low $83.18 Median $3,630.78 Typical High $9,772.37 | Facility | None | $83.18 | $3,630.78 | $9,772.37 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $48.98 Median $89.13 Typical High $89.13 | Professional | None | $48.98 | $89.13 | $89.13 |
Mass General Brigham Setting Facility Modifier None Typical Low $97.72 Median $104.71 Typical High $338.84 | Facility | None | $97.72 | $104.71 | $338.84 |
Mass General Brigham Setting Professional Modifier None Typical Low $51.29 Median $85.11 Typical High $660.69 | Professional | None | $51.29 | $85.11 | $660.69 |
United Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
United Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $67.61 | Professional | None | $33.88 | $51.29 | $67.61 |
Well Sense Setting Facility Modifier None Typical Low $72.44 Median $100.00 Typical High $147.91 | Facility | None | $72.44 | $100.00 | $147.91 |
Well Sense Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $141.25 | Professional | None | $61.66 | $61.66 | $141.25 |
7 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 $32.36 Median $32.36 Typical High $33.11 | Professional | 52 · Reduced service | $32.36 | $32.36 | $33.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $12.88 Typical High $13.49 | Professional | 53 · Discontinued | $12.88 | $12.88 | $13.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $9.77 Typical High $10.00 | Professional | 55 · Aftercare only | $9.77 | $9.77 | $10.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $6.46 Typical High $6.76 | Professional | 56 · Pre-op care only | $6.46 | $6.46 | $6.76 |
United Setting Professional Modifier CD · Dialysis lab test, bundled Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | CD · Dialysis lab test, bundled | $50.12 | $50.12 | $50.12 |
United Setting Professional Modifier CM · 80–99% impaired Typical Low $70.79 Median $70.79 Typical High $70.79 | Professional | CM · 80–99% impaired | $70.79 | $70.79 | $70.79 |
United Setting Professional Modifier XC Typical Low $1,513.56 Median $1,513.56 Typical High $1,513.56 | Professional | XC | $1,513.56 | $1,513.56 | $1,513.56 |
Where Massachusetts sits
The same service costs 2.6 times more in Hawaii than in Indiana. 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· 34th of 51
$67.61
HI $126IN $47.86
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.