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 $114.82 Median $354.81 Typical High $354.81 | Professional | None | $114.82 | $354.81 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $1,071.52 Typical High $3,019.95 | Facility | None | $194.98 | $1,071.52 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $120.23 Median $194.98 Typical High $208.93 | Professional | None | $120.23 | $194.98 | $208.93 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $181.97 Median $199.53 Typical High $229.09 | Facility | None | $181.97 | $199.53 | $229.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $128.82 Median $199.53 Typical High $213.80 | Professional | None | $128.82 | $199.53 | $213.80 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $1,071.52 Typical High $3,019.95 | Facility | None | $194.98 | $1,071.52 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $177.83 Typical High $199.53 | Professional | None | $79.43 | $177.83 | $199.53 |
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 $173.78 Median $199.53 Typical High $234.42 | Professional | None | $173.78 | $199.53 | $234.42 |
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 $57.54 Median $177.83 Typical High $177.83 | Professional | 52 · Reduced service | $57.54 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $70.79 Typical High $70.79 | Professional | 53 · Discontinued | $22.91 | $70.79 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $87.10 Median $269.15 Typical High $269.15 | Professional | 54 · Surgery only | $87.10 | $269.15 | $269.15 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $53.70 Typical High $53.70 | Professional | 55 · Aftercare only | $17.38 | $53.70 | $53.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $35.48 Typical High $35.48 | Professional | 56 · Pre-op care only | $11.48 | $35.48 | $35.48 |
Where Montana sits
The same service costs 6.0 times more in Alaska than in Kentucky. 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
$195
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.