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 $2,187.76 Median $2,691.53 Typical High $7,079.46 | Professional | None | $2,187.76 | $2,691.53 | $7,079.46 |
BCBS Montana Setting Professional Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Professional | None | $3,890.45 | $3,890.45 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Cigna Setting Professional Modifier None Typical Low $2,570.40 Median $3,890.45 Typical High $4,168.69 | Professional | None | $2,570.40 | $3,890.45 | $4,168.69 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,467.37 Median $3,890.45 Typical High $4,466.84 | Facility | None | $3,467.37 | $3,890.45 | $4,466.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,511.89 Median $3,890.45 Typical High $4,168.69 | Professional | None | $2,511.89 | $3,890.45 | $4,168.69 |
Providence Setting Facility Modifier None Typical Low $3,890.45 Median $3,890.45 Typical High $3,890.45 | Facility | None | $3,890.45 | $3,890.45 | $3,890.45 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,548.13 Typical High $3,981.07 | Professional | None | $79.43 | $3,548.13 | $3,981.07 |
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 $3,467.37 Median $4,073.80 Typical High $4,786.30 | Professional | None | $3,467.37 | $4,073.80 | $4,786.30 |
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 $1,122.02 Median $3,548.13 Typical High $3,548.13 | Professional | 52 · Reduced service | $1,122.02 | $3,548.13 | $3,548.13 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $457.09 Median $1,412.54 Typical High $1,412.54 | Professional | 53 · Discontinued | $457.09 | $1,412.54 | $1,412.54 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,698.24 Median $5,248.07 Typical High $5,248.07 | Professional | 54 · Surgery only | $1,698.24 | $5,248.07 | $5,248.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $338.84 Median $1,071.52 Typical High $1,071.52 | Professional | 55 · Aftercare only | $338.84 | $1,071.52 | $1,071.52 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $223.87 Median $707.95 Typical High $707.95 | Professional | 56 · Pre-op care only | $223.87 | $707.95 | $707.95 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,584.89 Median $4,897.79 Typical High $4,897.79 | Professional | 78 · Unplanned return to OR | $1,584.89 | $4,897.79 | $4,897.79 |
Where Montana sits
The same service costs 21.4 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· 14th of 51
$3,890
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.