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 $128.82 Median $398.11 Typical High $398.11 | Professional | None | $128.82 | $398.11 | $398.11 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $1,445.44 Typical High $4,073.80 | Facility | None | $208.93 | $1,445.44 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $199.53 Median $208.93 Typical High $363.08 | Professional | None | $199.53 | $208.93 | $363.08 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $204.17 Median $208.93 Typical High $316.23 | Facility | None | $204.17 | $208.93 | $316.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $131.83 Median $204.17 Typical High $218.78 | Professional | None | $131.83 | $204.17 | $218.78 |
Providence Setting Facility Modifier None Typical Low $208.93 Median $1,445.44 Typical High $4,073.80 | Facility | None | $208.93 | $1,445.44 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $229.09 | Professional | None | $79.43 | $190.55 | $229.09 |
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 $199.53 Median $229.09 Typical High $354.81 | Professional | None | $199.53 | $229.09 | $354.81 |
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 $64.57 Median $199.53 Typical High $199.53 | Professional | 52 · Reduced service | $64.57 | $199.53 | $199.53 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $79.43 Typical High $79.43 | Professional | 53 · Discontinued | $25.70 | $79.43 | $79.43 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $97.72 Median $295.12 Typical High $295.12 | Professional | 54 · Surgery only | $97.72 | $295.12 | $295.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.50 Median $58.88 Typical High $58.88 | Professional | 55 · Aftercare only | $19.50 | $58.88 | $58.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $39.81 Typical High $39.81 | Professional | 56 · Pre-op care only | $12.88 | $39.81 | $39.81 |
Where Montana sits
The same service costs 5.4 times more in Alaska than in Utah. 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
$209
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.