How much rates vary
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 Professional Modifier None Typical Low $51.29 Median $158.49 Typical High $158.49 | Professional | None | $51.29 | $158.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $389.05 Typical High $1,122.02 | Facility | None | $77.62 | $389.05 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $77.62 Typical High $85.11 | Professional | None | $64.57 | $77.62 | $85.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $83.18 | Facility | None | $72.44 | $72.44 | $83.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $46.77 Median $72.44 Typical High $77.62 | Professional | None | $46.77 | $72.44 | $77.62 |
Providence Setting Facility Modifier None Typical Low $77.62 Median $389.05 Typical High $1,122.02 | Facility | None | $77.62 | $389.05 | $1,122.02 |
Providence Setting Professional Modifier None Typical Low $52.48 Median $77.62 Typical High $79.43 | Professional | None | $52.48 | $77.62 | $79.43 |
United Setting Facility Modifier None Typical Low $186.21 Median $199.53 Typical High $524.81 | Facility | None | $186.21 | $199.53 | $524.81 |
United Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $97.72 | Professional | None | $74.13 | $87.10 | $97.72 |
5 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 $25.70 Median $79.43 Typical High $79.43 | Professional | 52 · Reduced service | $25.70 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $10.23 Median $31.62 Typical High $31.62 | Professional | 53 · Discontinued | $10.23 | $31.62 | $31.62 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $38.02 Median $120.23 Typical High $120.23 | Professional | 54 · Surgery only | $38.02 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.59 Median $23.99 Typical High $23.99 | Professional | 55 · Aftercare only | $7.59 | $23.99 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.13 Median $15.85 Typical High $15.85 | Professional | 56 · Pre-op care only | $5.13 | $15.85 | $15.85 |
Where Montana sits
The same service costs 4.2 times more in Alaska than in Florida. 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· 18th of 51
$77.62
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.