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 $707.95 Median $2,187.76 Typical High $2,187.76 | Professional | None | $707.95 | $2,187.76 | $2,187.76 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,202.26 | $4,897.79 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,202.26 Typical High $1,288.25 | Professional | None | $812.83 | $1,202.26 | $1,288.25 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,071.52 Median $1,258.93 Typical High $1,445.44 | Facility | None | $1,071.52 | $1,258.93 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,348.96 | Professional | None | $812.83 | $1,258.93 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $1,202.26 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,202.26 | $4,897.79 | $13,803.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,122.02 Typical High $1,230.27 | Professional | None | $79.43 | $1,122.02 | $1,230.27 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $3,311.31 Typical High $9,120.11 | Facility | None | $2,691.53 | $3,311.31 | $9,120.11 |
United Setting Professional Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,479.11 | Professional | None | $1,096.48 | $1,258.93 | $1,479.11 |
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 $354.81 Median $1,096.48 Typical High $1,096.48 | Professional | 52 · Reduced service | $354.81 | $1,096.48 | $1,096.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $141.25 Median $436.52 Typical High $436.52 | Professional | 53 · Discontinued | $141.25 | $436.52 | $436.52 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $537.03 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $107.15 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $70.79 Median $218.78 Typical High $218.78 | Professional | 56 · Pre-op care only | $70.79 | $218.78 | $218.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $501.19 | $1,548.82 | $1,548.82 |
Where Montana sits
The same service costs 25.1 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
$1,202
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.