How much rates vary
Facilitymedian $447 · 10th to 90th $200 to $1,000Professionalmedian $275 · 10th to 90th $129 to $646
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 $123.03 Median $380.19 Typical High $1,148.15 | Professional | None | $123.03 | $380.19 | $1,148.15 |
BCBS Montana Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $602.56 | Professional | None | $204.17 | $204.17 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $1,445.44 Typical High $4,073.80 | Facility | None | $204.17 | $1,445.44 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $363.08 Typical High $602.56 | Professional | None | $194.98 | $363.08 | $602.56 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $199.53 Median $234.42 Typical High $776.25 | Facility | None | $199.53 | $234.42 | $776.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $128.82 Median $245.47 Typical High $758.58 | Professional | None | $128.82 | $245.47 | $758.58 |
Providence Setting Facility Modifier None Typical Low $204.17 Median $1,445.44 Typical High $4,073.80 | Facility | None | $204.17 | $1,445.44 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $204.17 Typical High $645.65 | Professional | None | $79.43 | $204.17 | $645.65 |
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 $204.17 Median $269.15 Typical High $645.65 | Professional | None | $204.17 | $269.15 | $645.65 |
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 $190.55 Typical High $575.44 | Professional | 52 · Reduced service | $64.57 | $190.55 | $575.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.70 Median $75.86 Typical High $229.09 | Professional | 53 · Discontinued | $25.70 | $75.86 | $229.09 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $95.50 Median $281.84 Typical High $851.14 | Professional | 54 · Surgery only | $95.50 | $281.84 | $851.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.05 Median $56.23 Typical High $173.78 | Professional | 55 · Aftercare only | $19.05 | $56.23 | $173.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.88 Median $38.02 Typical High $114.82 | Professional | 56 · Pre-op care only | $12.88 | $38.02 | $114.82 |
Where Montana sits
The same service costs 5.7 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,090MT $722
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.