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 $776.25 Median $2,398.83 Typical High $2,398.83 | Professional | None | $776.25 | $2,398.83 | $2,398.83 |
Cigna Setting Facility Modifier None Typical Low $1,288.25 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,288.25 | $4,897.79 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $851.14 Median $1,288.25 Typical High $1,412.54 | Professional | None | $851.14 | $1,288.25 | $1,412.54 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,412.54 | Facility | None | $1,230.27 | $1,230.27 | $1,412.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $794.33 Median $1,230.27 Typical High $1,318.26 | Professional | None | $794.33 | $1,230.27 | $1,318.26 |
Providence Setting Facility Modifier None Typical Low $1,288.25 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,288.25 | $4,897.79 | $13,803.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,174.90 Typical High $1,318.26 | Professional | None | $79.43 | $1,174.90 | $1,318.26 |
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 $1,174.90 Median $1,380.38 Typical High $1,621.81 | Professional | None | $1,174.90 | $1,380.38 | $1,621.81 |
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 $389.05 Median $1,202.26 Typical High $1,202.26 | Professional | 52 · Reduced service | $389.05 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $154.88 Median $478.63 Typical High $478.63 | Professional | 53 · Discontinued | $154.88 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $588.84 Median $1,819.70 Typical High $1,819.70 | Professional | 54 · Surgery only | $588.84 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $117.49 Median $363.08 Typical High $363.08 | Professional | 55 · Aftercare only | $117.49 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $77.62 Median $239.88 Typical High $239.88 | Professional | 56 · Pre-op care only | $77.62 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $549.54 Median $1,698.24 Typical High $1,698.24 | Professional | 78 · Unplanned return to OR | $549.54 | $1,698.24 | $1,698.24 |
Where Montana sits
The same service costs 6.5 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
$1,288
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.