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 $162.18 Median $263.03 Typical High $758.58 | Professional | None | $162.18 | $263.03 | $758.58 |
BCBS Montana Setting Facility Modifier None Typical Low $302.00 Median $302.00 Typical High $302.00 | Facility | None | $302.00 | $302.00 | $302.00 |
BCBS Montana Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $398.11 | Professional | None | $251.19 | $251.19 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $295.12 Typical High $6,760.83 | Facility | None | $251.19 | $295.12 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $309.03 Typical High $398.11 | Professional | None | $234.42 | $309.03 | $398.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $257.04 Median $302.00 Typical High $489.78 | Facility | None | $257.04 | $302.00 | $489.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $165.96 Median $275.42 Typical High $478.63 | Professional | None | $165.96 | $275.42 | $478.63 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $295.12 Typical High $6,760.83 | Facility | None | $251.19 | $295.12 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $263.03 Typical High $416.87 | Professional | None | $79.43 | $263.03 | $416.87 |
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 $263.03 Median $354.81 Typical High $478.63 | Professional | None | $263.03 | $354.81 | $478.63 |
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 $83.18 Median $239.88 Typical High $380.19 | Professional | 52 · Reduced service | $83.18 | $239.88 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.11 Median $95.50 Typical High $151.36 | Professional | 53 · Discontinued | $33.11 | $95.50 | $151.36 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $123.03 Median $354.81 Typical High $562.34 | Professional | 54 · Surgery only | $123.03 | $354.81 | $562.34 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.12 Median $72.44 Typical High $112.20 | Professional | 55 · Aftercare only | $25.12 | $72.44 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.60 Median $47.86 Typical High $75.86 | Professional | 56 · Pre-op care only | $16.60 | $47.86 | $75.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $114.82 Median $331.13 Typical High $524.81 | Professional | 78 · Unplanned return to OR | $114.82 | $331.13 | $524.81 |
Where Montana sits
The same service costs 3.6 times more in Alaska than in Texas. 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· 25th of 51
$282
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.