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 $165.96 Median $537.03 Typical High $537.03 | Professional | None | $165.96 | $537.03 | $537.03 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $389.05 Typical High $1,122.02 | Facility | None | $263.03 | $389.05 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $263.03 Typical High $275.42 | Professional | None | $177.83 | $263.03 | $275.42 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $154.88 Median $245.47 Typical High $281.84 | Facility | None | $154.88 | $245.47 | $281.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $158.49 Median $245.47 Typical High $263.03 | Professional | None | $158.49 | $245.47 | $263.03 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $389.05 Typical High $1,122.02 | Facility | None | $263.03 | $389.05 | $1,122.02 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $245.47 Typical High $269.15 | Professional | None | $79.43 | $245.47 | $269.15 |
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 $186.21 Median $275.42 Typical High $316.23 | Professional | None | $186.21 | $275.42 | $316.23 |
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 $83.18 Median $269.15 Typical High $269.15 | Professional | 52 · Reduced service | $83.18 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $107.15 Typical High $107.15 | Professional | 53 · Discontinued | $33.11 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $125.89 Median $407.38 Typical High $407.38 | Professional | 54 · Surgery only | $125.89 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $81.28 Typical High $81.28 | Professional | 55 · Aftercare only | $25.12 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $53.70 Typical High $53.70 | Professional | 56 · Pre-op care only | $16.60 | $53.70 | $53.70 |
Where Montana sits
The same service costs 4.6 times more in Alaska 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.
Montana· 14th of 51
$263
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.