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 $104.71 Median $323.59 Typical High $524.81 | Professional | None | $104.71 | $323.59 | $524.81 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $204.17 Typical High $1,348.96 | Facility | None | $169.82 | $204.17 | $1,348.96 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $186.21 Typical High $281.84 | Professional | None | $154.88 | $186.21 | $281.84 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $165.96 Median $204.17 Typical High $346.74 | Facility | None | $165.96 | $204.17 | $346.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $109.65 Median $194.98 Typical High $338.84 | Professional | None | $109.65 | $194.98 | $338.84 |
Providence Setting Facility Modifier None Typical Low $169.82 Median $204.17 Typical High $1,348.96 | Facility | None | $169.82 | $204.17 | $1,348.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $288.40 | Professional | None | $79.43 | $173.78 | $288.40 |
United Setting Facility Modifier None Typical Low $186.21 Median $199.53 Typical High $524.81 | Facility | None | $186.21 | $199.53 | $524.81 |
United Setting Professional Modifier None Typical Low $169.82 Median $223.87 Typical High $323.59 | Professional | None | $169.82 | $223.87 | $323.59 |
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 $52.48 Median $162.18 Typical High $263.03 | Professional | 52 · Reduced service | $52.48 | $162.18 | $263.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $64.57 Typical High $104.71 | Professional | 53 · Discontinued | $21.38 | $64.57 | $104.71 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $79.43 Median $239.88 Typical High $389.05 | Professional | 54 · Surgery only | $79.43 | $239.88 | $389.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $47.86 Typical High $77.62 | Professional | 55 · Aftercare only | $15.85 | $47.86 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $32.36 Typical High $52.48 | Professional | 56 · Pre-op care only | $10.47 | $32.36 | $52.48 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $74.13 Median $223.87 Typical High $363.08 | Professional | 78 · Unplanned return to OR | $74.13 | $223.87 | $363.08 |
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· 23rd of 51
$186
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.