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 $912.01 Median $2,884.03 Typical High $2,884.03 | Professional | None | $912.01 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $1,548.82 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,548.82 | $4,897.79 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $1,000.00 Median $1,548.82 Typical High $1,548.82 | Professional | None | $1,000.00 | $1,548.82 | $1,548.82 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,318.26 Median $1,659.59 Typical High $1,905.46 | Facility | None | $1,318.26 | $1,659.59 | $1,905.46 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,071.52 Median $1,659.59 Typical High $1,778.28 | Professional | None | $1,071.52 | $1,659.59 | $1,778.28 |
Providence Setting Facility Modifier None Typical Low $1,548.82 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,548.82 | $4,897.79 | $13,803.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,412.54 Typical High $1,584.89 | Professional | None | $79.43 | $1,412.54 | $1,584.89 |
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 $1,348.96 Median $1,584.89 Typical High $1,905.46 | Professional | None | $1,348.96 | $1,584.89 | $1,905.46 |
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 $457.09 Median $1,412.54 Typical High $1,412.54 | Professional | 52 · Reduced service | $457.09 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $181.97 Median $575.44 Typical High $575.44 | Professional | 53 · Discontinued | $181.97 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $691.83 Median $2,137.96 Typical High $2,137.96 | Professional | 54 · Surgery only | $691.83 | $2,137.96 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $138.04 Median $426.58 Typical High $426.58 | Professional | 55 · Aftercare only | $138.04 | $426.58 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $91.20 Median $288.40 Typical High $288.40 | Professional | 56 · Pre-op care only | $91.20 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $645.65 Median $1,995.26 Typical High $1,995.26 | Professional | 78 · Unplanned return to OR | $645.65 | $1,995.26 | $1,995.26 |
Where Montana sits
The same service costs 5.8 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
$1,549
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.