How much rates vary
Facilitymedian $309 · 10th to 90th $302 to $1,445Professionalmedian $309 · 10th to 90th $182 to $468
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 $186.21 Median $245.47 Typical High $588.84 | Professional | None | $186.21 | $245.47 | $588.84 |
BCBS Montana Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
Cigna Setting Facility Modifier None Typical Low $309.03 Median $1,445.44 Typical High $4,073.80 | Facility | None | $309.03 | $1,445.44 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $309.03 Typical High $588.84 | Professional | None | $288.40 | $309.03 | $588.84 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $302.00 Median $309.03 Typical High $380.19 | Facility | None | $302.00 | $309.03 | $380.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $194.98 Median $302.00 Typical High $323.59 | Professional | None | $194.98 | $302.00 | $323.59 |
Providence Setting Facility Modifier None Typical Low $309.03 Median $1,445.44 Typical High $4,073.80 | Facility | None | $309.03 | $1,445.44 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $281.84 Typical High $354.81 | Professional | None | $79.43 | $281.84 | $354.81 |
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 $295.12 Median $338.84 Typical High $602.56 | Professional | None | $295.12 | $338.84 | $602.56 |
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 $93.33 Median $181.97 Typical High $295.12 | Professional | 52 · Reduced service | $93.33 | $181.97 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $72.44 Typical High $117.49 | Professional | 53 · Discontinued | $38.02 | $72.44 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $141.25 Median $275.42 Typical High $436.52 | Professional | 54 · Surgery only | $141.25 | $275.42 | $436.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.18 Median $54.95 Typical High $87.10 | Professional | 55 · Aftercare only | $28.18 | $54.95 | $87.10 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $18.62 Median $36.31 Typical High $58.88 | Professional | 56 · Pre-op care only | $18.62 | $36.31 | $58.88 |
Where Montana sits
The same service costs 6.8 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 $4,179MT $618
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.