How much rates vary
Facilitymedian $269 · 10th to 90th $107 to $468Professionalmedian $148 · 10th to 90th $105 to $295
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 $147.91 Median $147.91 Typical High $467.74 | Facility | None | $147.91 | $147.91 | $467.74 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $147.91 Typical High $147.91 | Professional | None | $114.82 | $147.91 | $147.91 |
AllWays Health Partners Setting Facility Modifier None Typical Low $223.87 Median $239.88 Typical High $269.15 | Facility | None | $223.87 | $239.88 | $269.15 |
AllWays Health Partners Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $1,122.02 | Professional | None | $104.71 | $190.55 | $1,122.02 |
BCBS Massachusetts Setting Facility Modifier None Typical Low $263.03 Median $302.00 Typical High $407.38 | Facility | None | $263.03 | $302.00 | $407.38 |
Cigna Setting Professional Modifier None Typical Low $89.13 Median $89.13 Typical High $89.13 | Professional | None | $89.13 | $89.13 | $89.13 |
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 $104.71 Median $204.17 Typical High $204.17 | Professional | None | $104.71 | $204.17 | $204.17 |
Mass General Brigham Setting Facility Modifier None Typical Low $223.87 Median $239.88 Typical High $269.15 | Facility | None | $223.87 | $239.88 | $269.15 |
Mass General Brigham Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $1,122.02 | Professional | None | $104.71 | $190.55 | $1,122.02 |
United Setting Facility Modifier None Typical Low $245.47 Median $245.47 Typical High $245.47 | Facility | None | $245.47 | $245.47 | $245.47 |
United Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $144.54 | Professional | None | $77.62 | $117.49 | $144.54 |
Well Sense Setting Facility Modifier None Typical Low $81.28 Median $112.20 Typical High $165.96 | Facility | None | $81.28 | $112.20 | $165.96 |
Well Sense Setting Professional Modifier None Typical Low $141.25 Median $141.25 Typical High $169.82 | Professional | None | $141.25 | $141.25 | $169.82 |
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 $57.54 Median $74.13 Typical High $74.13 | Professional | 52 · Reduced service | $57.54 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $29.51 Typical High $29.51 | Professional | 53 · Discontinued | $22.91 | $29.51 | $29.51 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $22.39 Typical High $22.39 | Professional | 55 · Aftercare only | $17.38 | $22.39 | $22.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $14.79 Typical High $14.79 | Professional | 56 · Pre-op care only | $11.48 | $14.79 | $14.79 |
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 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· 24th of 51
$148
MN $229UT $89.13
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.