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 $524.81 Median $1,621.81 Typical High $1,621.81 | Professional | None | $524.81 | $1,621.81 | $1,621.81 |
Cigna Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $3,019.95 | Facility | None | $891.25 | $1,071.52 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $602.56 Median $891.25 Typical High $954.99 | Professional | None | $602.56 | $891.25 | $954.99 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $776.25 Median $933.25 Typical High $1,071.52 | Facility | None | $776.25 | $933.25 | $1,071.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $616.60 Median $933.25 Typical High $1,000.00 | Professional | None | $616.60 | $933.25 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $891.25 Median $1,071.52 Typical High $3,019.95 | Facility | None | $891.25 | $1,071.52 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $812.83 Typical High $912.01 | Professional | None | $79.43 | $812.83 | $912.01 |
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 $794.33 Median $912.01 Typical High $1,096.48 | Professional | None | $794.33 | $912.01 | $1,096.48 |
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 $263.03 Median $812.83 Typical High $812.83 | Professional | 52 · Reduced service | $263.03 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $104.71 Median $323.59 Typical High $323.59 | Professional | 53 · Discontinued | $104.71 | $323.59 | $323.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $398.11 Median $1,230.27 Typical High $1,230.27 | Professional | 54 · Surgery only | $398.11 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $79.43 Median $245.47 Typical High $245.47 | Professional | 55 · Aftercare only | $79.43 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $52.48 Median $162.18 Typical High $162.18 | Professional | 56 · Pre-op care only | $52.48 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $371.54 Median $1,148.15 Typical High $1,148.15 | Professional | 78 · Unplanned return to OR | $371.54 | $1,148.15 | $1,148.15 |
Where Montana sits
The same service costs 5.5 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
$891
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.