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 $218.78 Median $691.83 Typical High $691.83 | Professional | None | $218.78 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $316.23 Median $380.19 Typical High $416.87 | Professional | None | $316.23 | $380.19 | $416.87 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $346.74 Median $371.54 Typical High $426.58 | Facility | None | $346.74 | $371.54 | $426.58 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $398.11 | Professional | None | $239.88 | $371.54 | $398.11 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $346.74 Typical High $389.05 | Professional | None | $79.43 | $346.74 | $389.05 |
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 $346.74 Median $407.38 Typical High $478.63 | Professional | None | $346.74 | $407.38 | $478.63 |
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 $109.65 Median $346.74 Typical High $346.74 | Professional | 52 · Reduced service | $109.65 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $138.04 Typical High $138.04 | Professional | 53 · Discontinued | $44.67 | $138.04 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $165.96 Median $524.81 Typical High $524.81 | Professional | 54 · Surgery only | $165.96 | $524.81 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $104.71 Typical High $104.71 | Professional | 55 · Aftercare only | $33.11 | $104.71 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $21.88 | $69.18 | $69.18 |
Where Montana sits
The same service costs 5.0 times more in Alaska than in Utah. 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
$380
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.