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 $151.36 Median $239.88 Typical High $630.96 | Professional | None | $151.36 | $239.88 | $630.96 |
BCBS Montana Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $338.84 | Professional | None | $251.19 | $251.19 | $338.84 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $1,071.52 Typical High $3,019.95 | Facility | None | $251.19 | $1,071.52 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $213.80 Median $257.04 Typical High $346.74 | Professional | None | $213.80 | $257.04 | $346.74 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $229.09 Median $281.84 Typical High $398.11 | Facility | None | $229.09 | $281.84 | $398.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $154.88 Median $257.04 Typical High $389.05 | Professional | None | $154.88 | $257.04 | $389.05 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $1,071.52 Typical High $3,019.95 | Facility | None | $251.19 | $1,071.52 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $245.47 Typical High $346.74 | Professional | None | $79.43 | $245.47 | $346.74 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,862.09 | Facility | None | $602.56 | $1,000.00 | $1,862.09 |
United Setting Professional Modifier None Typical Low $234.42 Median $302.00 Typical High $389.05 | Professional | None | $234.42 | $302.00 | $389.05 |
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 $75.86 Median $223.87 Typical High $316.23 | Professional | 52 · Reduced service | $75.86 | $223.87 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $30.20 Median $91.20 Typical High $125.89 | Professional | 53 · Discontinued | $30.20 | $91.20 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $112.20 Median $338.84 Typical High $467.74 | Professional | 54 · Surgery only | $112.20 | $338.84 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $22.39 Median $67.61 Typical High $95.50 | Professional | 55 · Aftercare only | $22.39 | $67.61 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.14 Median $44.67 Typical High $63.10 | Professional | 56 · Pre-op care only | $15.14 | $44.67 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $104.71 Median $316.23 Typical High $436.52 | Professional | 78 · Unplanned return to OR | $104.71 | $316.23 | $436.52 |
Where Montana sits
The same service costs 4.2 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· 19th of 51
$257
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.