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 $1,174.90 Median $3,715.35 Typical High $3,715.35 | Professional | None | $1,174.90 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $2,137.96 | Professional | None | $1,348.96 | $2,041.74 | $2,137.96 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,344.23 | Facility | None | $1,819.70 | $2,041.74 | $2,344.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $2,187.76 | Professional | None | $1,318.26 | $2,041.74 | $2,187.76 |
Providence Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,862.09 Typical High $2,089.30 | Professional | None | $79.43 | $1,862.09 | $2,089.30 |
United Setting Facility Modifier None Typical Low $2,089.30 Median $3,981.07 Typical High $7,079.46 | Facility | None | $2,089.30 | $3,981.07 | $7,079.46 |
United Setting Professional Modifier None Typical Low $1,778.28 Median $2,137.96 Typical High $2,511.89 | Professional | None | $1,778.28 | $2,137.96 | $2,511.89 |
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 $588.84 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $588.84 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $741.31 Typical High $741.31 | Professional | 53 · Discontinued | $234.42 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $891.25 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $177.83 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $177.83 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $117.49 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $831.76 | $2,570.40 | $2,570.40 |
Where Montana sits
The same service costs 26.3 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
$2,042
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.