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 $125.89 Median $213.80 Typical High $676.08 | Professional | None | $125.89 | $213.80 | $676.08 |
BCBS Montana Setting Facility Modifier None Typical Low $239.88 Median $239.88 Typical High $239.88 | Facility | None | $239.88 | $239.88 | $239.88 |
BCBS Montana Setting Professional Modifier None Typical Low $173.78 Median $173.78 Typical High $309.03 | Professional | None | $173.78 | $173.78 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $275.42 Typical High $6,760.83 | Facility | None | $208.93 | $275.42 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $186.21 Median $229.09 Typical High $363.08 | Professional | None | $186.21 | $229.09 | $363.08 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $204.17 Median $251.19 Typical High $416.87 | Facility | None | $204.17 | $251.19 | $416.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $131.83 Median $239.88 Typical High $416.87 | Professional | None | $131.83 | $239.88 | $416.87 |
Providence Setting Facility Modifier None Typical Low $208.93 Median $275.42 Typical High $6,760.83 | Facility | None | $208.93 | $275.42 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $208.93 Typical High $371.54 | Professional | None | $79.43 | $208.93 | $371.54 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,862.09 | Facility | None | $602.56 | $1,000.00 | $1,862.09 |
United Setting Professional Modifier None Typical Low $199.53 Median $281.84 Typical High $398.11 | Professional | None | $199.53 | $281.84 | $398.11 |
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 $63.10 Median $190.55 Typical High $338.84 | Professional | 52 · Reduced service | $63.10 | $190.55 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $75.86 Typical High $134.90 | Professional | 53 · Discontinued | $25.70 | $75.86 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $281.84 Typical High $501.19 | Professional | 54 · Surgery only | $95.50 | $281.84 | $501.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $56.23 Typical High $100.00 | Professional | 55 · Aftercare only | $19.05 | $56.23 | $100.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.59 Median $38.02 Typical High $67.61 | Professional | 56 · Pre-op care only | $12.59 | $38.02 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $89.13 Median $263.03 Typical High $467.74 | Professional | 78 · Unplanned return to OR | $89.13 | $263.03 | $467.74 |
Where Montana sits
The same service costs 3.3 times more in Alaska than in Washington, DC. 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
$224
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.