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 $954.99 Median $3,235.94 Typical High $3,235.94 | Professional | None | $954.99 | $3,235.94 | $3,235.94 |
Cigna Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,862.09 Typical High $1,862.09 | Professional | None | $1,258.93 | $1,862.09 | $1,862.09 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,778.28 Median $1,819.70 Typical High $2,089.30 | Facility | None | $1,778.28 | $1,819.70 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,148.15 Median $1,778.28 Typical High $1,905.46 | Professional | None | $1,148.15 | $1,778.28 | $1,905.46 |
Providence Setting Facility Modifier None Typical Low $1,862.09 Median $1,862.09 Typical High $1,862.09 | Facility | None | $1,862.09 | $1,862.09 | $1,862.09 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,621.81 Typical High $1,862.09 | Professional | None | $79.43 | $1,621.81 | $1,862.09 |
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 $1,513.56 Median $1,778.28 Typical High $2,041.74 | Professional | None | $1,513.56 | $1,778.28 | $2,041.74 |
3 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 54 · Surgery only Typical Low $724.44 Median $2,398.83 Typical High $2,398.83 | Professional | 54 · Surgery only | $724.44 | $2,398.83 | $2,398.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $144.54 Median $478.63 Typical High $478.63 | Professional | 55 · Aftercare only | $144.54 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $95.50 Median $323.59 Typical High $323.59 | Professional | 56 · Pre-op care only | $95.50 | $323.59 | $323.59 |
Where Montana sits
The same service costs 5.6 times more in Alaska than in New York. 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· 16th of 51
$1,778
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.