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 $54.95 Median $79.43 Typical High $218.78 | Professional | None | $54.95 | $79.43 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $93.33 Typical High $3,019.95 | Facility | None | $77.62 | $93.33 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $79.43 Median $100.00 Typical High $138.04 | Professional | None | $79.43 | $100.00 | $138.04 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $87.10 Median $107.15 Typical High $141.25 | Facility | None | $87.10 | $107.15 | $141.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $58.88 Median $97.72 Typical High $141.25 | Professional | None | $58.88 | $97.72 | $141.25 |
Providence Setting Facility Modifier None Typical Low $77.62 Median $93.33 Typical High $3,019.95 | Facility | None | $77.62 | $93.33 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $72.44 Median $91.20 Typical High $120.23 | Professional | None | $72.44 | $91.20 | $120.23 |
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 $89.13 Median $112.20 Typical High $141.25 | Professional | None | $89.13 | $112.20 | $141.25 |
5 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 $28.84 Median $85.11 Typical High $109.65 | Professional | 52 · Reduced service | $28.84 | $85.11 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $33.88 Typical High $43.65 | Professional | 53 · Discontinued | $11.48 | $33.88 | $43.65 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $42.66 Median $125.89 Typical High $162.18 | Professional | 54 · Surgery only | $42.66 | $125.89 | $162.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $25.12 Typical High $32.36 | Professional | 55 · Aftercare only | $8.51 | $25.12 | $32.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $16.98 Typical High $21.88 | Professional | 56 · Pre-op care only | $5.75 | $16.98 | $21.88 |
Where Montana sits
The same service costs 4.3 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
$95.50
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.