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 $1,949.84 Median $6,025.60 Typical High $6,025.60 | Professional | None | $1,949.84 | $6,025.60 | $6,025.60 |
Cigna Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Cigna Setting Professional Modifier None Typical Low $2,238.72 Median $3,311.31 Typical High $3,311.31 | Professional | None | $2,238.72 | $3,311.31 | $3,311.31 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,162.28 Median $3,235.94 Typical High $3,715.35 | Facility | None | $3,162.28 | $3,235.94 | $3,715.35 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,041.74 Median $3,162.28 Typical High $3,388.44 | Professional | None | $2,041.74 | $3,162.28 | $3,388.44 |
Providence Setting Facility Modifier None Typical Low $3,311.31 Median $3,311.31 Typical High $3,311.31 | Facility | None | $3,311.31 | $3,311.31 | $3,311.31 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,019.95 Typical High $3,388.44 | Professional | None | $79.43 | $3,019.95 | $3,388.44 |
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 $2,951.21 Median $3,467.37 Typical High $4,073.80 | Professional | None | $2,951.21 | $3,467.37 | $4,073.80 |
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 $954.99 Median $3,019.95 Typical High $3,019.95 | Professional | 52 · Reduced service | $954.99 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $389.05 Median $1,202.26 Typical High $1,202.26 | Professional | 53 · Discontinued | $389.05 | $1,202.26 | $1,202.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,445.44 Median $4,570.88 Typical High $4,570.88 | Professional | 54 · Surgery only | $1,445.44 | $4,570.88 | $4,570.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $288.40 Median $912.01 Typical High $912.01 | Professional | 55 · Aftercare only | $288.40 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $194.98 Median $602.56 Typical High $602.56 | Professional | 56 · Pre-op care only | $194.98 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,348.96 Median $4,265.80 Typical High $4,265.80 | Professional | 78 · Unplanned return to OR | $1,348.96 | $4,265.80 | $4,265.80 |
Where Montana sits
The same service costs 9.8 times more in Alaska than in Kentucky. 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
$3,311
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.