How much rates vary
Facilitymedian $170 · 10th to 90th $71 to $295Professionalmedian $93 · 10th to 90th $66 to $186
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 $93.33 Median $93.33 Typical High $295.12 | Facility | None | $93.33 | $93.33 | $295.12 |
Aetna Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | None | $85.11 | $93.33 | $93.33 |
AllWays Health Partners Setting Facility Modifier None Typical Low $141.25 Median $151.36 Typical High $169.82 | Facility | None | $141.25 | $151.36 | $169.82 |
AllWays Health Partners Setting Professional Modifier None Typical Low $69.18 Median $120.23 Typical High $812.83 | Professional | None | $69.18 | $120.23 | $812.83 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $165.96 Median $190.55 Typical High $257.04 | Facility | None | $165.96 | $190.55 | $257.04 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $66.07 Median $128.82 Typical High $128.82 | Professional | None | $66.07 | $128.82 | $128.82 |
Mass General Brigham Setting Facility Modifier None Typical Low $141.25 Median $151.36 Typical High $169.82 | Facility | None | $141.25 | $151.36 | $169.82 |
Mass General Brigham Setting Professional Modifier None Typical Low $69.18 Median $120.23 Typical High $812.83 | Professional | None | $69.18 | $120.23 | $812.83 |
United Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
United Setting Professional Modifier None Typical Low $48.98 Median $74.13 Typical High $97.72 | Professional | None | $48.98 | $74.13 | $97.72 |
Well Sense Setting Facility Modifier None Typical Low $51.29 Median $70.79 Typical High $104.71 | Facility | None | $51.29 | $70.79 | $104.71 |
Well Sense Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $107.15 | Professional | None | $89.13 | $89.13 | $107.15 |
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 $42.66 Median $46.77 Typical High $46.77 | Professional | 52 · Reduced service | $42.66 | $46.77 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.62 Typical High $18.62 | Professional | 53 · Discontinued | $16.98 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.13 Typical High $14.13 | Professional | 55 · Aftercare only | $12.88 | $14.13 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.33 Typical High $9.33 | Professional | 56 · Pre-op care only | $8.51 | $9.33 | $9.33 |
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 2.5 times more in Minnesota than in Utah. 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· 33rd of 51
$93.33
MN $151UT $61.66
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.