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 $74.13 Median $74.13 Typical High $100.00 | Professional | None | $74.13 | $74.13 | $100.00 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $158.49 | Facility | None | $134.90 | $134.90 | $158.49 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $97.72 Median $147.91 Typical High $169.82 | Facility | None | $97.72 | $147.91 | $169.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $93.33 Median $154.88 Typical High $154.88 | Professional | None | $93.33 | $154.88 | $154.88 |
Providence Setting Facility Modifier None Typical Low $134.90 Median $134.90 Typical High $158.49 | Facility | None | $134.90 | $134.90 | $158.49 |
Providence Setting Professional Modifier None Typical Low $134.90 Median $134.90 Typical High $134.90 | Professional | None | $134.90 | $134.90 | $134.90 |
United Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $154.88 | Professional | None | $120.23 | $141.25 | $154.88 |
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 $37.15 Median $37.15 Typical High $48.98 | Professional | 52 · Reduced service | $37.15 | $37.15 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $15.14 Typical High $19.95 | Professional | 53 · Discontinued | $14.79 | $15.14 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $11.22 Typical High $14.79 | Professional | 55 · Aftercare only | $11.22 | $11.22 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $10.00 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $10.00 |
Where Montana sits
The same service costs 12.6 times more in California than in Kentucky. 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· 11th of 51
$135
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.