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 $2,630.27 Median $8,128.31 Typical High $8,128.31 | Professional | None | $2,630.27 | $8,128.31 | $8,128.31 |
Cigna Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Cigna Setting Professional Modifier None Typical Low $2,951.21 Median $4,466.84 Typical High $4,897.79 | Professional | None | $2,951.21 | $4,466.84 | $4,897.79 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $4,168.69 Median $4,570.88 Typical High $5,248.07 | Facility | None | $4,168.69 | $4,570.88 | $5,248.07 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,951.21 Median $4,570.88 Typical High $4,897.79 | Professional | None | $2,951.21 | $4,570.88 | $4,897.79 |
Providence Setting Facility Modifier None Typical Low $4,466.84 Median $4,466.84 Typical High $4,466.84 | Facility | None | $4,466.84 | $4,466.84 | $4,466.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $4,073.80 Typical High $4,570.88 | Professional | None | $79.43 | $4,073.80 | $4,570.88 |
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 $4,073.80 Median $4,786.30 Typical High $5,495.41 | Professional | None | $4,073.80 | $4,786.30 | $5,495.41 |
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 $1,318.26 Median $4,073.80 Typical High $4,073.80 | Professional | 52 · Reduced service | $1,318.26 | $4,073.80 | $4,073.80 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $1,621.81 Typical High $1,621.81 | Professional | 53 · Discontinued | $524.81 | $1,621.81 | $1,621.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,949.84 Median $6,025.60 Typical High $6,025.60 | Professional | 54 · Surgery only | $1,949.84 | $6,025.60 | $6,025.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $389.05 Median $1,202.26 Typical High $1,202.26 | Professional | 55 · Aftercare only | $389.05 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $812.83 Typical High $812.83 | Professional | 56 · Pre-op care only | $263.03 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,819.70 Median $5,623.41 Typical High $5,623.41 | Professional | 78 · Unplanned return to OR | $1,819.70 | $5,623.41 | $5,623.41 |
Where Montana sits
The same service costs 5.1 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· 14th of 51
$4,467
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.