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 $416.87 Median $1,318.26 Typical High $1,318.26 | Professional | None | $416.87 | $1,318.26 | $1,318.26 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $2,398.83 Typical High $6,760.83 | Facility | None | $724.44 | $2,398.83 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $724.44 Typical High $724.44 | Professional | None | $467.74 | $724.44 | $724.44 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $602.56 Median $741.31 Typical High $851.14 | Facility | None | $602.56 | $741.31 | $851.14 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $478.63 Median $741.31 Typical High $794.33 | Professional | None | $478.63 | $741.31 | $794.33 |
Providence Setting Facility Modifier None Typical Low $724.44 Median $2,398.83 Typical High $6,760.83 | Facility | None | $724.44 | $2,398.83 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $660.69 Typical High $741.31 | Professional | None | $79.43 | $660.69 | $741.31 |
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 $630.96 Median $707.95 Typical High $851.14 | Professional | None | $630.96 | $707.95 | $851.14 |
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 $208.93 Median $660.69 Typical High $660.69 | Professional | 52 · Reduced service | $208.93 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $83.18 Median $263.03 Typical High $263.03 | Professional | 53 · Discontinued | $83.18 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $316.23 Median $1,000.00 Typical High $1,000.00 | Professional | 54 · Surgery only | $316.23 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $63.10 Median $199.53 Typical High $199.53 | Professional | 55 · Aftercare only | $63.10 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $41.69 Median $131.83 Typical High $131.83 | Professional | 56 · Pre-op care only | $41.69 | $131.83 | $131.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $295.12 Median $933.25 Typical High $933.25 | Professional | 78 · Unplanned return to OR | $295.12 | $933.25 | $933.25 |
Where Montana sits
The same service costs 6.2 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· 14th of 51
$724
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.