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 $691.83 Median $2,187.76 Typical High $2,187.76 | Professional | None | $691.83 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,174.90 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,174.90 | $4,897.79 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $776.25 Median $1,174.90 Typical High $1,230.27 | Professional | None | $776.25 | $1,174.90 | $1,230.27 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,071.52 Median $1,174.90 Typical High $1,348.96 | Facility | None | $1,071.52 | $1,174.90 | $1,348.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $758.58 Median $1,174.90 Typical High $1,258.93 | Professional | None | $758.58 | $1,174.90 | $1,258.93 |
Providence Setting Facility Modifier None Typical Low $1,174.90 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,174.90 | $4,897.79 | $13,803.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,071.52 Typical High $1,202.26 | Professional | None | $79.43 | $1,071.52 | $1,202.26 |
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 $1,202.26 Typical High $1,412.54 | Professional | None | $1,023.29 | $1,202.26 | $1,412.54 |
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 $346.74 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $346.74 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $138.04 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $512.86 Median $1,621.81 Typical High $1,621.81 | Professional | 54 · Surgery only | $512.86 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $323.59 Typical High $323.59 | Professional | 55 · Aftercare only | $102.33 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $69.18 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $478.63 Median $1,513.56 Typical High $1,513.56 | Professional | 78 · Unplanned return to OR | $478.63 | $1,513.56 | $1,513.56 |
Where Montana sits
The same service costs 6.2 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
$1,175
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.