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 $218.78 Median $645.65 Typical High $1,023.29 | Professional | None | $218.78 | $645.65 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $3,019.95 | Facility | None | $354.81 | $416.87 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $363.08 Typical High $562.34 | Professional | None | $316.23 | $363.08 | $562.34 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $338.84 Median $407.38 Typical High $707.95 | Facility | None | $338.84 | $407.38 | $707.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $223.87 Median $398.11 Typical High $691.83 | Professional | None | $223.87 | $398.11 | $691.83 |
Providence Setting Facility Modifier None Typical Low $354.81 Median $416.87 Typical High $3,019.95 | Facility | None | $354.81 | $416.87 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $354.81 Typical High $562.34 | Professional | None | $79.43 | $354.81 | $562.34 |
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 $338.84 Median $446.68 Typical High $630.96 | Professional | None | $338.84 | $446.68 | $630.96 |
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 $109.65 Median $323.59 Typical High $512.86 | Professional | 52 · Reduced service | $109.65 | $323.59 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $128.82 Typical High $204.17 | Professional | 53 · Discontinued | $43.65 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $478.63 Typical High $758.58 | Professional | 54 · Surgery only | $162.18 | $478.63 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $95.50 Typical High $151.36 | Professional | 55 · Aftercare only | $33.11 | $95.50 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $64.57 Typical High $102.33 | Professional | 56 · Pre-op care only | $21.88 | $64.57 | $102.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $446.68 Typical High $707.95 | Professional | 78 · Unplanned return to OR | $151.36 | $446.68 | $707.95 |
Where Montana sits
The same service costs 3.6 times more in Alaska than in New Jersey. 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· 24th of 51
$372
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.