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 $112.20 Median $316.23 Typical High $630.96 | Professional | None | $112.20 | $316.23 | $630.96 |
BCBS Montana Setting Professional Modifier None Typical Low $181.97 Median $181.97 Typical High $363.08 | Professional | None | $181.97 | $181.97 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $208.93 Typical High $588.84 | Facility | None | $181.97 | $208.93 | $588.84 |
Cigna Setting Professional Modifier None Typical Low $173.78 Median $234.42 Typical High $363.08 | Professional | None | $173.78 | $234.42 | $363.08 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $190.55 Median $234.42 Typical High $426.58 | Facility | None | $190.55 | $234.42 | $426.58 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $123.03 Median $234.42 Typical High $426.58 | Professional | None | $123.03 | $234.42 | $426.58 |
Providence Setting Facility Modifier None Typical Low $181.97 Median $208.93 Typical High $588.84 | Facility | None | $181.97 | $208.93 | $588.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $181.97 Typical High $363.08 | Professional | None | $79.43 | $181.97 | $363.08 |
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 $181.97 Median $281.84 Typical High $389.05 | Professional | None | $181.97 | $281.84 | $389.05 |
6 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 $56.23 Median $158.49 Typical High $316.23 | Professional | 52 · Reduced service | $56.23 | $158.49 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $63.10 Typical High $125.89 | Professional | 53 · Discontinued | $22.39 | $63.10 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $85.11 Median $239.88 Typical High $467.74 | Professional | 54 · Surgery only | $85.11 | $239.88 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $47.86 Typical High $93.33 | Professional | 55 · Aftercare only | $16.98 | $47.86 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $31.62 Typical High $63.10 | Professional | 56 · Pre-op care only | $11.22 | $31.62 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $79.43 Median $223.87 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $79.43 | $223.87 | $436.52 |
Where Montana sits
The same service costs 3.5 times more in Alaska than in Texas. 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· 26th of 51
$209
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.