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 $81.28 Median $295.12 Typical High $1,023.29 | Professional | None | $81.28 | $295.12 | $1,023.29 |
BCBS Montana Setting Professional Modifier None Typical Low $138.04 Median $138.04 Typical High $138.04 | Professional | None | $138.04 | $138.04 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $223.87 Typical High $630.96 | Facility | None | $138.04 | $223.87 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $288.40 Typical High $524.81 | Professional | None | $123.03 | $288.40 | $524.81 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $141.25 Median $177.83 Typical High $691.83 | Facility | None | $141.25 | $177.83 | $691.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $91.20 Median $173.78 Typical High $676.08 | Professional | None | $91.20 | $173.78 | $676.08 |
Providence Setting Facility Modifier None Typical Low $138.04 Median $223.87 Typical High $630.96 | Facility | None | $138.04 | $223.87 | $630.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $575.44 | Professional | None | $79.43 | $138.04 | $575.44 |
United Setting Facility Modifier None Typical Low $186.21 Median $199.53 Typical High $524.81 | Facility | None | $186.21 | $199.53 | $524.81 |
United Setting Professional Modifier None Typical Low $131.83 Median $331.13 Typical High $616.60 | Professional | None | $131.83 | $331.13 | $616.60 |
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 $41.69 Median $147.91 Typical High $512.86 | Professional | 52 · Reduced service | $41.69 | $147.91 | $512.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $58.88 Typical High $204.17 | Professional | 53 · Discontinued | $16.60 | $58.88 | $204.17 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $218.78 Typical High $758.58 | Professional | 54 · Surgery only | $63.10 | $218.78 | $758.58 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $44.67 Typical High $151.36 | Professional | 55 · Aftercare only | $12.59 | $44.67 | $151.36 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $29.51 Typical High $102.33 | Professional | 56 · Pre-op care only | $8.32 | $29.51 | $102.33 |
Where Montana sits
The same service costs 4.8 times more in Wisconsin than in Washington, DC. 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· 43rd of 51
$219
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.