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 $229.09 Median $707.95 Typical High $707.95 | Professional | None | $229.09 | $707.95 | $707.95 |
BCBS Montana Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $2,398.83 Typical High $6,760.83 | Facility | None | $389.05 | $2,398.83 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $269.15 Median $389.05 Typical High $389.05 | Professional | None | $269.15 | $389.05 | $389.05 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $363.08 Median $398.11 Typical High $457.09 | Facility | None | $363.08 | $398.11 | $457.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $426.58 | Professional | None | $257.04 | $398.11 | $426.58 |
Providence Setting Facility Modifier None Typical Low $389.05 Median $2,398.83 Typical High $6,760.83 | Facility | None | $389.05 | $2,398.83 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $354.81 Typical High $398.11 | Professional | None | $79.43 | $354.81 | $398.11 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $3,162.28 | Facility | None | $1,445.44 | $2,238.72 | $3,162.28 |
United Setting Professional Modifier None Typical Low $346.74 Median $398.11 Typical High $467.74 | Professional | None | $346.74 | $398.11 | $467.74 |
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 $114.82 Median $354.81 Typical High $354.81 | Professional | 52 · Reduced service | $114.82 | $354.81 | $354.81 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $46.77 Median $141.25 Typical High $141.25 | Professional | 53 · Discontinued | $46.77 | $141.25 | $141.25 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $173.78 Median $537.03 Typical High $537.03 | Professional | 54 · Surgery only | $173.78 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $34.67 Median $107.15 Typical High $107.15 | Professional | 55 · Aftercare only | $34.67 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $22.91 Median $70.79 Typical High $70.79 | Professional | 56 · Pre-op care only | $22.91 | $70.79 | $70.79 |
Where Montana sits
The same service costs 4.6 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· 12th of 51
$389
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.