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 $102.33 Median $147.91 Typical High $426.58 | Professional | None | $102.33 | $147.91 | $426.58 |
BCBS Montana Setting Facility Modifier None Typical Low $154.88 Median $154.88 Typical High $154.88 | Facility | None | $154.88 | $154.88 | $154.88 |
BCBS Montana Setting Professional Modifier None Typical Low $158.49 Median $173.78 Typical High $234.42 | Professional | None | $158.49 | $173.78 | $234.42 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $173.78 Typical High $3,019.95 | Facility | None | $162.18 | $173.78 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $186.21 Typical High $251.19 | Professional | None | $147.91 | $186.21 | $251.19 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $162.18 Median $204.17 Typical High $275.42 | Facility | None | $162.18 | $204.17 | $275.42 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $112.20 Median $186.21 Typical High $275.42 | Professional | None | $112.20 | $186.21 | $275.42 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $173.78 Typical High $3,019.95 | Facility | None | $162.18 | $173.78 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $239.88 | Professional | None | $79.43 | $173.78 | $239.88 |
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 $165.96 Median $208.93 Typical High $269.15 | Professional | None | $165.96 | $208.93 | $269.15 |
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 $52.48 Median $158.49 Typical High $213.80 | Professional | 52 · Reduced service | $52.48 | $158.49 | $213.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $63.10 Typical High $85.11 | Professional | 53 · Discontinued | $21.38 | $63.10 | $85.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $239.88 Typical High $323.59 | Professional | 54 · Surgery only | $79.43 | $239.88 | $323.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $47.86 Typical High $64.57 | Professional | 55 · Aftercare only | $15.85 | $47.86 | $64.57 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $31.62 Typical High $42.66 | Professional | 56 · Pre-op care only | $10.72 | $31.62 | $42.66 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $223.87 Typical High $302.00 | Professional | 78 · Unplanned return to OR | $74.13 | $223.87 | $302.00 |
Where Montana sits
The same service costs 4.0 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· 18th of 51
$178
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.