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 $1,288.25 Median $4,073.80 Typical High $4,073.80 | Professional | None | $1,288.25 | $4,073.80 | $4,073.80 |
Cigna Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Cigna Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $2,398.83 | Professional | None | $1,479.11 | $2,238.72 | $2,398.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,995.26 Median $2,238.72 Typical High $2,570.40 | Facility | None | $1,995.26 | $2,238.72 | $2,570.40 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,479.11 Median $2,238.72 Typical High $2,398.83 | Professional | None | $1,479.11 | $2,238.72 | $2,398.83 |
Providence Setting Facility Modifier None Typical Low $2,238.72 Median $2,238.72 Typical High $2,238.72 | Facility | None | $2,238.72 | $2,238.72 | $2,238.72 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $2,041.74 Typical High $2,290.87 | Professional | None | $79.43 | $2,041.74 | $2,290.87 |
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 $1,995.26 Median $2,344.23 Typical High $2,754.23 | Professional | None | $1,995.26 | $2,344.23 | $2,754.23 |
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 $645.65 Median $2,041.74 Typical High $2,041.74 | Professional | 52 · Reduced service | $645.65 | $2,041.74 | $2,041.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $263.03 Median $812.83 Typical High $812.83 | Professional | 53 · Discontinued | $263.03 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $977.24 Median $3,019.95 Typical High $3,019.95 | Professional | 54 · Surgery only | $977.24 | $3,019.95 | $3,019.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $194.98 Median $602.56 Typical High $602.56 | Professional | 55 · Aftercare only | $194.98 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $128.82 Median $407.38 Typical High $407.38 | Professional | 56 · Pre-op care only | $128.82 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $912.01 Median $2,818.38 Typical High $2,818.38 | Professional | 78 · Unplanned return to OR | $912.01 | $2,818.38 | $2,818.38 |
Where Montana sits
The same service costs 5.2 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
$2,239
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.