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 $158.49 Median $467.74 Typical High $1,258.93 | Professional | None | $158.49 | $467.74 | $1,258.93 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $1,445.44 Typical High $4,073.80 | Facility | None | $251.19 | $1,445.44 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $245.47 Median $416.87 Typical High $660.69 | Professional | None | $245.47 | $416.87 | $660.69 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $245.47 Median $309.03 Typical High $870.96 | Facility | None | $245.47 | $309.03 | $870.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $158.49 Median $295.12 Typical High $851.14 | Professional | None | $158.49 | $295.12 | $851.14 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $1,445.44 Typical High $4,073.80 | Facility | None | $251.19 | $1,445.44 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $251.19 Typical High $691.83 | Professional | None | $79.43 | $251.19 | $691.83 |
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 $251.19 Median $457.09 Typical High $724.44 | Professional | None | $251.19 | $457.09 | $724.44 |
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 $79.43 Median $234.42 Typical High $630.96 | Professional | 52 · Reduced service | $79.43 | $234.42 | $630.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $31.62 Median $93.33 Typical High $251.19 | Professional | 53 · Discontinued | $31.62 | $93.33 | $251.19 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $117.49 Median $354.81 Typical High $954.99 | Professional | 54 · Surgery only | $117.49 | $354.81 | $954.99 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $23.44 Median $70.79 Typical High $190.55 | Professional | 55 · Aftercare only | $23.44 | $70.79 | $190.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $15.85 Median $46.77 Typical High $125.89 | Professional | 56 · Pre-op care only | $15.85 | $46.77 | $125.89 |
Where Montana sits
The same service costs 4.5 times more in Alaska than in Washington, DC. 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· 29th of 51
$380
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.