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 $676.08 Median $2,041.74 Typical High $2,041.74 | Professional | None | $676.08 | $2,041.74 | $2,041.74 |
Cigna Setting Facility Modifier None Typical Low $1,122.02 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,122.02 | $4,897.79 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $707.95 Median $1,122.02 Typical High $1,202.26 | Professional | None | $707.95 | $1,122.02 | $1,202.26 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $977.24 Median $1,096.48 Typical High $1,288.25 | Facility | None | $977.24 | $1,096.48 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $724.44 Median $1,096.48 Typical High $1,174.90 | Professional | None | $724.44 | $1,096.48 | $1,174.90 |
Providence Setting Facility Modifier None Typical Low $1,122.02 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,122.02 | $4,897.79 | $13,803.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,023.29 Typical High $1,122.02 | Professional | None | $79.43 | $1,023.29 | $1,122.02 |
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 $1,023.29 Median $1,174.90 Typical High $1,380.38 | Professional | None | $1,023.29 | $1,174.90 | $1,380.38 |
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 $338.84 Median $1,023.29 Typical High $1,023.29 | Professional | 52 · Reduced service | $338.84 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $134.90 Median $407.38 Typical High $407.38 | Professional | 53 · Discontinued | $134.90 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $1,513.56 Typical High $1,513.56 | Professional | 54 · Surgery only | $512.86 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $302.00 Typical High $302.00 | Professional | 55 · Aftercare only | $102.33 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $67.61 Median $204.17 Typical High $204.17 | Professional | 56 · Pre-op care only | $67.61 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $1,412.54 Typical High $1,412.54 | Professional | 78 · Unplanned return to OR | $478.63 | $1,412.54 | $1,412.54 |
Where Montana sits
The same service costs 6.3 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· 15th of 51
$1,122
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.