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 $660.69 Median $1,949.84 Typical High $2,511.89 | Professional | None | $660.69 | $1,949.84 | $2,511.89 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,071.52 | $4,897.79 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,071.52 Typical High $1,380.38 | Professional | None | $851.14 | $1,071.52 | $1,380.38 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $977.24 Median $1,174.90 Typical High $1,584.89 | Facility | None | $977.24 | $1,174.90 | $1,584.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $645.65 Median $1,071.52 Typical High $1,548.82 | Professional | None | $645.65 | $1,071.52 | $1,548.82 |
Providence Setting Facility Modifier None Typical Low $1,071.52 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,071.52 | $4,897.79 | $13,803.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,071.52 Typical High $1,380.38 | Professional | None | $79.43 | $1,071.52 | $1,380.38 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $3,162.28 | Facility | None | $1,445.44 | $2,238.72 | $3,162.28 |
United Setting Professional Modifier None Typical Low $1,023.29 Median $1,202.26 Typical High $1,513.56 | Professional | None | $1,023.29 | $1,202.26 | $1,513.56 |
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 $331.13 Median $977.24 Typical High $1,258.93 | Professional | 52 · Reduced service | $331.13 | $977.24 | $1,258.93 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $131.83 Median $389.05 Typical High $501.19 | Professional | 53 · Discontinued | $131.83 | $389.05 | $501.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $489.78 Median $1,479.11 Typical High $1,905.46 | Professional | 54 · Surgery only | $489.78 | $1,479.11 | $1,905.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $100.00 Median $295.12 Typical High $380.19 | Professional | 55 · Aftercare only | $100.00 | $295.12 | $380.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $66.07 Median $194.98 Typical High $251.19 | Professional | 56 · Pre-op care only | $66.07 | $194.98 | $251.19 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $457.09 Median $1,380.38 Typical High $1,778.28 | Professional | 78 · Unplanned return to OR | $457.09 | $1,380.38 | $1,778.28 |
Where Montana sits
The same service costs 4.4 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· 18th of 51
$1,072
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.