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 $380.19 Median $1,202.26 Typical High $1,202.26 | Professional | None | $380.19 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $588.84 Typical High $660.69 | Facility | None | $208.93 | $588.84 | $660.69 |
Cigna Setting Professional Modifier None Typical Low $407.38 Median $660.69 Typical High $691.83 | Professional | None | $407.38 | $660.69 | $691.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $588.84 Median $616.60 Typical High $707.95 | Facility | None | $588.84 | $616.60 | $707.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $660.69 | Professional | None | $398.11 | $616.60 | $660.69 |
Providence Setting Facility Modifier None Typical Low $208.93 Median $588.84 Typical High $660.69 | Facility | None | $208.93 | $588.84 | $660.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $588.84 Typical High $660.69 | Professional | None | $79.43 | $588.84 | $660.69 |
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 $575.44 Median $676.08 Typical High $776.25 | Professional | None | $575.44 | $676.08 | $776.25 |
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 $190.55 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $190.55 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $75.86 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $912.01 Typical High $912.01 | Professional | 54 · Surgery only | $288.40 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $57.54 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $38.02 | $120.23 | $120.23 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $851.14 Typical High $851.14 | Professional | 78 · Unplanned return to OR | $269.15 | $851.14 | $851.14 |
Where Montana sits
The same service costs 4.2 times more in Wyoming than in Utah. 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· 13th of 51
$661
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.