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 $2,630.27 Median $8,317.64 Typical High $8,317.64 | Professional | None | $2,630.27 | $8,317.64 | $8,317.64 |
Cigna Setting Facility Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,570.88 | $4,570.88 | $4,570.88 |
Cigna Setting Professional Modifier None Typical Low $3,019.95 Median $4,570.88 Typical High $4,570.88 | Professional | None | $3,019.95 | $4,570.88 | $4,570.88 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $4,168.69 Median $4,570.88 Typical High $5,370.32 | Facility | None | $4,168.69 | $4,570.88 | $5,370.32 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $3,019.95 Median $4,570.88 Typical High $4,897.79 | Professional | None | $3,019.95 | $4,570.88 | $4,897.79 |
Providence Setting Facility Modifier None Typical Low $4,570.88 Median $4,570.88 Typical High $4,570.88 | Facility | None | $4,570.88 | $4,570.88 | $4,570.88 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $4,168.69 Typical High $4,677.35 | Professional | None | $79.43 | $4,168.69 | $4,677.35 |
United Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $1,862.09 | Facility | None | $602.56 | $954.99 | $1,862.09 |
United Setting Professional Modifier None Typical Low $3,890.45 Median $4,570.88 Typical High $5,370.32 | Professional | None | $3,890.45 | $4,570.88 | $5,370.32 |
6 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 $1,318.26 Median $4,168.69 Typical High $4,168.69 | Professional | 52 · Reduced service | $1,318.26 | $4,168.69 | $4,168.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $524.81 Median $1,659.59 Typical High $1,659.59 | Professional | 53 · Discontinued | $524.81 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,995.26 Median $6,165.95 Typical High $6,165.95 | Professional | 54 · Surgery only | $1,995.26 | $6,165.95 | $6,165.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $398.11 Median $1,230.27 Typical High $1,230.27 | Professional | 55 · Aftercare only | $398.11 | $1,230.27 | $1,230.27 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $263.03 Median $831.76 Typical High $831.76 | Professional | 56 · Pre-op care only | $263.03 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,862.09 Median $5,754.40 Typical High $5,754.40 | Professional | 78 · Unplanned return to OR | $1,862.09 | $5,754.40 | $5,754.40 |
Where Montana sits
The same service costs 21.4 times more in Alaska than in Texas. 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· 15th of 51
$4,571
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.