How much rates vary
Facilitymedian $631 · 10th to 90th $295 to $1,445Professionalmedian $372 · 10th to 90th $200 to $832
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 Facility Modifier None Typical Low $1,584.89 Median $3,467.37 Typical High $4,265.80 | Facility | None | $1,584.89 | $3,467.37 | $4,265.80 |
Aetna Setting Professional Modifier None Typical Low $190.55 Median $478.63 Typical High $1,479.11 | Professional | None | $190.55 | $478.63 | $1,479.11 |
BCBS Montana Setting Facility Modifier None Typical Low $1,584.89 Median $1,584.89 Typical High $1,584.89 | Facility | None | $1,584.89 | $1,584.89 | $1,584.89 |
BCBS Montana Setting Professional Modifier None Typical Low $302.00 Median $660.69 Typical High $776.25 | Professional | None | $302.00 | $660.69 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $302.00 Median $1,445.44 Typical High $4,073.80 | Facility | None | $302.00 | $1,445.44 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $295.12 Median $478.63 Typical High $776.25 | Professional | None | $295.12 | $478.63 | $776.25 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $295.12 Median $346.74 Typical High $1,023.29 | Facility | None | $295.12 | $346.74 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $190.55 Median $363.08 Typical High $1,000.00 | Professional | None | $190.55 | $363.08 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $302.00 Median $1,445.44 Typical High $4,073.80 | Facility | None | $302.00 | $1,445.44 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $309.03 Typical High $831.76 | Professional | None | $79.43 | $309.03 | $831.76 |
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 $309.03 Median $407.38 Typical High $851.14 | Professional | None | $309.03 | $407.38 | $851.14 |
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 $95.50 Median $288.40 Typical High $741.31 | Professional | 52 · Reduced service | $95.50 | $288.40 | $741.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $114.82 Typical High $295.12 | Professional | 53 · Discontinued | $38.02 | $114.82 | $295.12 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $144.54 Median $426.58 Typical High $1,122.02 | Professional | 54 · Surgery only | $144.54 | $426.58 | $1,122.02 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $87.10 Typical High $223.87 | Professional | 55 · Aftercare only | $28.84 | $87.10 | $223.87 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $57.54 Typical High $147.91 | Professional | 56 · Pre-op care only | $19.05 | $57.54 | $147.91 |
Where Montana sits
The same service costs 4.1 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 $4,142MT $1,002
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.