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 $1,380.38 Median $4,168.69 Typical High $4,168.69 | Professional | None | $1,380.38 | $4,168.69 | $4,168.69 |
Cigna Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Cigna Setting Professional Modifier None Typical Low $1,513.56 Median $2,290.87 Typical High $2,454.71 | Professional | None | $1,513.56 | $2,290.87 | $2,454.71 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,089.30 Median $2,398.83 Typical High $2,754.23 | Facility | None | $2,089.30 | $2,398.83 | $2,754.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,548.82 Median $2,398.83 Typical High $2,570.40 | Professional | None | $1,548.82 | $2,398.83 | $2,570.40 |
Providence Setting Facility Modifier None Typical Low $2,290.87 Median $2,290.87 Typical High $2,290.87 | Facility | None | $2,290.87 | $2,290.87 | $2,290.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,089.30 Typical High $2,344.23 | Professional | None | $79.43 | $2,089.30 | $2,344.23 |
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 $2,041.74 Median $2,454.71 Typical High $2,818.38 | Professional | None | $2,041.74 | $2,454.71 | $2,818.38 |
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 $691.83 Median $2,089.30 Typical High $2,089.30 | Professional | 52 · Reduced service | $691.83 | $2,089.30 | $2,089.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $275.42 Median $831.76 Typical High $831.76 | Professional | 53 · Discontinued | $275.42 | $831.76 | $831.76 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,023.29 Median $3,090.30 Typical High $3,090.30 | Professional | 54 · Surgery only | $1,023.29 | $3,090.30 | $3,090.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $208.93 Median $616.60 Typical High $616.60 | Professional | 55 · Aftercare only | $208.93 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $138.04 Median $416.87 Typical High $416.87 | Professional | 56 · Pre-op care only | $138.04 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $954.99 Median $2,884.03 Typical High $2,884.03 | Professional | 78 · Unplanned return to OR | $954.99 | $2,884.03 | $2,884.03 |
Where Montana sits
The same service costs 5.0 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· 14th of 51
$2,291
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.