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 $288.40 Median $870.96 Typical High $1,348.96 | Professional | None | $288.40 | $870.96 | $1,348.96 |
Cigna Setting Facility Modifier None Typical Low $489.78 Median $645.65 Typical High $6,760.83 | Facility | None | $489.78 | $645.65 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $380.19 Median $489.78 Typical High $741.31 | Professional | None | $380.19 | $489.78 | $741.31 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $512.86 Median $588.84 Typical High $954.99 | Facility | None | $512.86 | $588.84 | $954.99 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $331.13 Median $562.34 Typical High $933.25 | Professional | None | $331.13 | $562.34 | $933.25 |
Providence Setting Facility Modifier None Typical Low $489.78 Median $645.65 Typical High $6,760.83 | Facility | None | $489.78 | $645.65 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $489.78 Typical High $758.58 | Professional | None | $79.43 | $489.78 | $758.58 |
United Setting Facility Modifier None Typical Low $2,089.30 Median $3,981.07 Typical High $7,079.46 | Facility | None | $2,089.30 | $3,981.07 | $7,079.46 |
United Setting Professional Modifier None Typical Low $426.58 Median $575.44 Typical High $812.83 | Professional | None | $426.58 | $575.44 | $812.83 |
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 $144.54 Median $436.52 Typical High $676.08 | Professional | 52 · Reduced service | $144.54 | $436.52 | $676.08 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $57.54 Median $173.78 Typical High $269.15 | Professional | 53 · Discontinued | $57.54 | $173.78 | $269.15 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $218.78 Median $645.65 Typical High $1,023.29 | Professional | 54 · Surgery only | $218.78 | $645.65 | $1,023.29 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $43.65 Median $128.82 Typical High $204.17 | Professional | 55 · Aftercare only | $43.65 | $128.82 | $204.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.84 Median $87.10 Typical High $134.90 | Professional | 56 · Pre-op care only | $28.84 | $87.10 | $134.90 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $204.17 Median $602.56 Typical High $954.99 | Professional | 78 · Unplanned return to OR | $204.17 | $602.56 | $954.99 |
Where Montana sits
The same service costs 4.3 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· 19th of 51
$513
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.