How much rates vary
Facilitymedian $245 · 10th to 90th $174 to $457Professionalmedian $126 · 10th to 90th $89 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 $125.89 Median $125.89 Typical High $398.11 | Facility | None | $125.89 | $125.89 | $398.11 |
Aetna Setting Professional Modifier None Typical Low $102.33 Median $125.89 Typical High $125.89 | Professional | None | $102.33 | $125.89 | $125.89 |
AllWays Health Partners Setting Facility Modifier None Typical Low $190.55 Median $204.17 Typical High $467.74 | Facility | None | $190.55 | $204.17 | $467.74 |
AllWays Health Partners Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $977.24 | Professional | None | $95.50 | $162.18 | $977.24 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $223.87 Median $257.04 Typical High $346.74 | Facility | None | $223.87 | $257.04 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
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 $89.13 Median $173.78 Typical High $173.78 | Professional | None | $89.13 | $173.78 | $173.78 |
Mass General Brigham Setting Facility Modifier None Typical Low $190.55 Median $204.17 Typical High $467.74 | Facility | None | $190.55 | $204.17 | $467.74 |
Mass General Brigham Setting Professional Modifier None Typical Low $95.50 Median $162.18 Typical High $977.24 | Professional | None | $95.50 | $162.18 | $977.24 |
United Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $204.17 | Facility | None | $204.17 | $204.17 | $204.17 |
United Setting Professional Modifier None Typical Low $66.07 Median $97.72 Typical High $120.23 | Professional | None | $66.07 | $97.72 | $120.23 |
Well Sense Setting Facility Modifier None Typical Low $141.25 Median $194.98 Typical High $288.40 | Facility | None | $141.25 | $194.98 | $288.40 |
Well Sense Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $275.42 | Professional | None | $120.23 | $120.23 | $275.42 |
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 $51.29 Median $63.10 Typical High $63.10 | Professional | 52 · Reduced service | $51.29 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.42 Median $25.12 Typical High $25.12 | Professional | 53 · Discontinued | $20.42 | $25.12 | $25.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $15.14 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.23 Median $12.59 Typical High $12.59 | Professional | 56 · Pre-op care only | $10.23 | $12.59 | $12.59 |
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 Montana than in Ohio. 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· 17th of 51
$126
MT $186OH $72.44
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.