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 $1,659.59 Median $5,128.61 Typical High $5,128.61 | Professional | None | $1,659.59 | $5,128.61 | $5,128.61 |
BCBS Montana Setting Professional Modifier None Typical Low $2,398.83 Median $2,884.03 Typical High $2,884.03 | Professional | None | $2,398.83 | $2,884.03 | $2,884.03 |
Cigna Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Cigna Setting Professional Modifier None Typical Low $1,862.09 Median $2,884.03 Typical High $3,019.95 | Professional | None | $1,862.09 | $2,884.03 | $3,019.95 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2,570.40 Median $2,884.03 Typical High $3,311.31 | Facility | None | $2,570.40 | $2,884.03 | $3,311.31 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,862.09 Median $2,884.03 Typical High $3,090.30 | Professional | None | $1,862.09 | $2,884.03 | $3,090.30 |
Providence Setting Facility Modifier None Typical Low $2,884.03 Median $2,884.03 Typical High $2,884.03 | Facility | None | $2,884.03 | $2,884.03 | $2,884.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,630.27 Typical High $2,884.03 | Professional | None | $79.43 | $2,630.27 | $2,884.03 |
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 $2,511.89 Median $3,019.95 Typical High $3,548.13 | Professional | None | $2,511.89 | $3,019.95 | $3,548.13 |
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 $831.76 Median $2,570.40 Typical High $2,570.40 | Professional | 52 · Reduced service | $831.76 | $2,570.40 | $2,570.40 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $331.13 Median $1,047.13 Typical High $1,047.13 | Professional | 53 · Discontinued | $331.13 | $1,047.13 | $1,047.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,258.93 Median $3,890.45 Typical High $3,890.45 | Professional | 54 · Surgery only | $1,258.93 | $3,890.45 | $3,890.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $251.19 Median $776.25 Typical High $776.25 | Professional | 55 · Aftercare only | $251.19 | $776.25 | $776.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $165.96 Median $512.86 Typical High $512.86 | Professional | 56 · Pre-op care only | $165.96 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,174.90 Median $3,630.78 Typical High $3,630.78 | Professional | 78 · Unplanned return to OR | $1,174.90 | $3,630.78 | $3,630.78 |
Where Montana sits
The same service costs 5.4 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· 13th of 51
$2,884
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.