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 $4,168.69 Median $12,882.50 Typical High $12,882.50 | Professional | None | $4,168.69 | $12,882.50 | $12,882.50 |
Cigna Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Facility | None | $6,918.31 | $6,918.31 | $6,918.31 |
Cigna Setting Professional Modifier None Typical Low $4,570.88 Median $6,918.31 Typical High $7,585.78 | Professional | None | $4,570.88 | $6,918.31 | $7,585.78 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $6,760.83 Median $7,079.46 Typical High $8,128.31 | Facility | None | $6,760.83 | $7,079.46 | $8,128.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,570.88 Median $7,079.46 Typical High $7,585.78 | Professional | None | $4,570.88 | $7,079.46 | $7,585.78 |
Providence Setting Facility Modifier None Typical Low $6,918.31 Median $6,918.31 Typical High $6,918.31 | Facility | None | $6,918.31 | $6,918.31 | $6,918.31 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $6,456.54 Typical High $7,079.46 | Professional | None | $79.43 | $6,456.54 | $7,079.46 |
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 $6,309.57 Median $7,585.78 Typical High $8,912.51 | Professional | None | $6,309.57 | $7,585.78 | $8,912.51 |
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 $2,089.30 Median $6,309.57 Typical High $6,309.57 | Professional | 52 · Reduced service | $2,089.30 | $6,309.57 | $6,309.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $831.76 Median $2,570.40 Typical High $2,570.40 | Professional | 53 · Discontinued | $831.76 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $3,162.28 Median $9,549.93 Typical High $9,549.93 | Professional | 54 · Surgery only | $3,162.28 | $9,549.93 | $9,549.93 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $630.96 Median $1,905.46 Typical High $1,905.46 | Professional | 55 · Aftercare only | $630.96 | $1,905.46 | $1,905.46 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $416.87 Median $1,288.25 Typical High $1,288.25 | Professional | 56 · Pre-op care only | $416.87 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $2,951.21 Median $8,912.51 Typical High $8,912.51 | Professional | 78 · Unplanned return to OR | $2,951.21 | $8,912.51 | $8,912.51 |
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· 15th of 51
$6,918
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.