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 $3,388.44 Median $10,232.93 Typical High $10,232.93 | Professional | None | $3,388.44 | $10,232.93 | $10,232.93 |
Cigna Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Cigna Setting Professional Modifier None Typical Low $3,715.35 Median $5,623.41 Typical High $6,165.95 | Professional | None | $3,715.35 | $5,623.41 | $6,165.95 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $5,370.32 Median $5,754.40 Typical High $6,606.93 | Facility | None | $5,370.32 | $5,754.40 | $6,606.93 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,715.35 Median $5,754.40 Typical High $6,165.95 | Professional | None | $3,715.35 | $5,754.40 | $6,165.95 |
Providence Setting Facility Modifier None Typical Low $5,623.41 Median $5,623.41 Typical High $5,623.41 | Facility | None | $5,623.41 | $5,623.41 | $5,623.41 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $5,128.61 Typical High $5,754.40 | Professional | None | $79.43 | $5,128.61 | $5,754.40 |
United Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $1,862.09 | Facility | None | $602.56 | $954.99 | $1,862.09 |
United Setting Professional Modifier None Typical Low $5,128.61 Median $6,165.95 Typical High $7,079.46 | Professional | None | $5,128.61 | $6,165.95 | $7,079.46 |
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 $1,698.24 Median $5,128.61 Typical High $5,128.61 | Professional | 52 · Reduced service | $1,698.24 | $5,128.61 | $5,128.61 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $676.08 Median $2,041.74 Typical High $2,041.74 | Professional | 53 · Discontinued | $676.08 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $2,511.89 Median $7,762.47 Typical High $7,762.47 | Professional | 54 · Surgery only | $2,511.89 | $7,762.47 | $7,762.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $501.19 Median $1,548.82 Typical High $1,548.82 | Professional | 55 · Aftercare only | $501.19 | $1,548.82 | $1,548.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $338.84 Median $1,023.29 Typical High $1,023.29 | Professional | 56 · Pre-op care only | $338.84 | $1,023.29 | $1,023.29 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,344.23 Median $7,244.36 Typical High $7,244.36 | Professional | 78 · Unplanned return to OR | $2,344.23 | $7,244.36 | $7,244.36 |
Where Montana sits
The same service costs 21.9 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· 13th of 51
$5,623
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.