How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $257.04 | Professional | None | $77.62 | $77.62 | $257.04 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $100.00 Median $151.36 Typical High $173.78 | Facility | None | $100.00 | $151.36 | $173.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $95.50 Median $158.49 Typical High $158.49 | Professional | None | $95.50 | $158.49 | $158.49 |
United Setting Professional Modifier None Typical Low $128.82 Median $151.36 Typical High $169.82 | Professional | None | $128.82 | $151.36 | $169.82 |
4 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 $38.90 Median $38.90 Typical High $128.82 | Professional | 52 · Reduced service | $38.90 | $38.90 | $128.82 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $15.49 Typical High $51.29 | Professional | 53 · Discontinued | $15.49 | $15.49 | $51.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $38.90 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $38.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $25.70 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $25.70 |
Where Montana sits
The same service costs 3.2 times more in Alaska than in New York. 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.
Montana· 7th of 51
$148
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.