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 $107.15 Median $331.13 Typical High $331.13 | Professional | None | $107.15 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $389.05 Typical High $1,122.02 | Facility | None | $165.96 | $389.05 | $1,122.02 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $165.96 Typical High $186.21 | Professional | None | $131.83 | $165.96 | $186.21 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $144.54 Median $151.36 Typical High $173.78 | Facility | None | $144.54 | $151.36 | $173.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $97.72 Median $151.36 Typical High $162.18 | Professional | None | $97.72 | $151.36 | $162.18 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $389.05 Typical High $1,122.02 | Facility | None | $165.96 | $389.05 | $1,122.02 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $151.36 Typical High $165.96 | Professional | None | $79.43 | $151.36 | $165.96 |
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 $147.91 Median $177.83 Typical High $199.53 | Professional | None | $147.91 | $177.83 | $199.53 |
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 $53.70 Median $162.18 Typical High $162.18 | Professional | 52 · Reduced service | $53.70 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $21.38 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $245.47 Typical High $245.47 | Professional | 54 · Surgery only | $79.43 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $48.98 Typical High $48.98 | Professional | 55 · Aftercare only | $15.85 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $10.72 | $33.11 | $33.11 |
Where Montana sits
The same service costs 4.8 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· 14th of 51
$166
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.