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 $81.28 Median $239.88 Typical High $562.34 | Professional | None | $81.28 | $239.88 | $562.34 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $229.09 Typical High $2,290.87 | Facility | None | $128.82 | $229.09 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $223.87 Typical High $302.00 | Professional | None | $123.03 | $223.87 | $302.00 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $117.49 Median $147.91 Typical High $363.08 | Facility | None | $117.49 | $147.91 | $363.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $75.86 Median $144.54 Typical High $363.08 | Professional | None | $75.86 | $144.54 | $363.08 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $229.09 Typical High $2,290.87 | Facility | None | $128.82 | $229.09 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $131.83 Typical High $316.23 | Professional | None | $79.43 | $131.83 | $316.23 |
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 $128.82 Median $234.42 Typical High $346.74 | Professional | None | $128.82 | $234.42 | $346.74 |
5 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 $40.74 Median $120.23 Typical High $281.84 | Professional | 52 · Reduced service | $40.74 | $120.23 | $281.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $47.86 Typical High $112.20 | Professional | 53 · Discontinued | $16.22 | $47.86 | $112.20 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $60.26 Median $181.97 Typical High $426.58 | Professional | 54 · Surgery only | $60.26 | $181.97 | $426.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $36.31 Typical High $85.11 | Professional | 55 · Aftercare only | $12.02 | $36.31 | $85.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $23.99 Typical High $56.23 | Professional | 56 · Pre-op care only | $8.13 | $23.99 | $56.23 |
Where Montana sits
The same service costs 3.7 times more in Alaska than in Maryland. 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· 27th of 51
$186
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.