How much rates vary
Facilitymedian $575 · 10th to 90th $562 to $1,445Professionalmedian $575 · 10th to 90th $339 to $692
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 $346.74 Median $380.19 Typical High $1,096.48 | Professional | None | $346.74 | $380.19 | $1,096.48 |
BCBS Montana Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $1,445.44 Typical High $4,073.80 | Facility | None | $575.44 | $1,445.44 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $575.44 Typical High $645.65 | Professional | None | $467.74 | $575.44 | $645.65 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $562.34 Median $562.34 Typical High $660.69 | Facility | None | $562.34 | $562.34 | $660.69 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $363.08 Median $562.34 Typical High $602.56 | Professional | None | $363.08 | $562.34 | $602.56 |
Providence Setting Facility Modifier None Typical Low $575.44 Median $1,445.44 Typical High $4,073.80 | Facility | None | $575.44 | $1,445.44 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $537.03 Typical High $588.84 | Professional | None | $79.43 | $537.03 | $588.84 |
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 $537.03 Median $645.65 Typical High $741.31 | Professional | None | $537.03 | $645.65 | $741.31 |
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 $181.97 Median $549.54 Typical High $549.54 | Professional | 52 · Reduced service | $181.97 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $72.44 Median $218.78 Typical High $218.78 | Professional | 53 · Discontinued | $72.44 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $257.04 Median $831.76 Typical High $831.76 | Professional | 54 · Surgery only | $257.04 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $165.96 Typical High $165.96 | Professional | 55 · Aftercare only | $53.70 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $36.31 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $36.31 | $109.65 | $109.65 |
Where Montana sits
The same service costs 5.0 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 $5,749MT $1,151
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.