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 $467.74 Median $1,445.44 Typical High $1,445.44 | Professional | None | $467.74 | $1,445.44 | $1,445.44 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $4,897.79 Typical High $13,803.84 | Facility | None | $794.33 | $4,897.79 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $794.33 Typical High $851.14 | Professional | None | $512.86 | $794.33 | $851.14 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $758.58 Median $758.58 Typical High $870.96 | Facility | None | $758.58 | $758.58 | $870.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $489.78 Median $758.58 Typical High $812.83 | Professional | None | $489.78 | $758.58 | $812.83 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $4,897.79 Typical High $13,803.84 | Facility | None | $794.33 | $4,897.79 | $13,803.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $707.95 Typical High $794.33 | Professional | None | $79.43 | $707.95 | $794.33 |
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 $691.83 Median $831.76 Typical High $977.24 | Professional | None | $691.83 | $831.76 | $977.24 |
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 $234.42 Median $724.44 Typical High $724.44 | Professional | 52 · Reduced service | $234.42 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $93.33 Median $288.40 Typical High $288.40 | Professional | 53 · Discontinued | $93.33 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $1,096.48 Typical High $1,096.48 | Professional | 54 · Surgery only | $354.81 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $218.78 Typical High $218.78 | Professional | 55 · Aftercare only | $70.79 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $46.77 Median $144.54 Typical High $144.54 | Professional | 56 · Pre-op care only | $46.77 | $144.54 | $144.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $331.13 Median $1,023.29 Typical High $1,023.29 | Professional | 78 · Unplanned return to OR | $331.13 | $1,023.29 | $1,023.29 |
Where Montana sits
The same service costs 6.3 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· 14th of 51
$794
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.