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 $138.04 Median $416.87 Typical High $676.08 | Professional | None | $138.04 | $416.87 | $676.08 |
Cigna Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $6,760.83 | Facility | None | $223.87 | $269.15 | $6,760.83 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $263.03 Typical High $363.08 | Professional | None | $204.17 | $263.03 | $363.08 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $218.78 Median $263.03 Typical High $426.58 | Facility | None | $218.78 | $263.03 | $426.58 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $141.25 Median $245.47 Typical High $426.58 | Professional | None | $141.25 | $245.47 | $426.58 |
Providence Setting Facility Modifier None Typical Low $223.87 Median $269.15 Typical High $6,760.83 | Facility | None | $223.87 | $269.15 | $6,760.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $229.09 Typical High $380.19 | Professional | None | $79.43 | $229.09 | $380.19 |
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 $223.87 Median $309.03 Typical High $426.58 | Professional | None | $223.87 | $309.03 | $426.58 |
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 $69.18 Median $208.93 Typical High $338.84 | Professional | 52 · Reduced service | $69.18 | $208.93 | $338.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $27.54 Median $83.18 Typical High $134.90 | Professional | 53 · Discontinued | $27.54 | $83.18 | $134.90 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $104.71 Median $309.03 Typical High $512.86 | Professional | 54 · Surgery only | $104.71 | $309.03 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $20.89 Median $63.10 Typical High $102.33 | Professional | 55 · Aftercare only | $20.89 | $63.10 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.80 Median $41.69 Typical High $67.61 | Professional | 56 · Pre-op care only | $13.80 | $41.69 | $67.61 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $97.72 Median $288.40 Typical High $478.63 | Professional | 78 · Unplanned return to OR | $97.72 | $288.40 | $478.63 |
Where Montana sits
The same service costs 3.5 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
$245
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.