How much rates vary
Facilitymedian $437 · 10th to 90th $427 to $1,445Professionalmedian $437 · 10th to 90th $224 to $525
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 $275.42 Median $389.05 Typical High $831.76 | Professional | None | $275.42 | $389.05 | $831.76 |
BCBS Montana Setting Professional Modifier None Typical Low $436.52 Median $436.52 Typical High $436.52 | Professional | None | $436.52 | $436.52 | $436.52 |
Cigna Setting Facility Modifier None Typical Low $436.52 Median $1,445.44 Typical High $4,073.80 | Facility | None | $436.52 | $1,445.44 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $363.08 Median $436.52 Typical High $489.78 | Professional | None | $363.08 | $436.52 | $489.78 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $426.58 Median $426.58 Typical High $489.78 | Facility | None | $426.58 | $426.58 | $489.78 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $275.42 Median $426.58 Typical High $457.09 | Professional | None | $275.42 | $426.58 | $457.09 |
Providence Setting Facility Modifier None Typical Low $436.52 Median $1,445.44 Typical High $4,073.80 | Facility | None | $436.52 | $1,445.44 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $407.38 Typical High $446.68 | Professional | None | $79.43 | $407.38 | $446.68 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,862.09 | Facility | None | $602.56 | $1,000.00 | $1,862.09 |
United Setting Professional Modifier None Typical Low $407.38 Median $478.63 Typical High $562.34 | Professional | None | $407.38 | $478.63 | $562.34 |
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 $134.90 Median $416.87 Typical High $416.87 | Professional | 52 · Reduced service | $134.90 | $416.87 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $165.96 Typical High $165.96 | Professional | 53 · Discontinued | $54.95 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $630.96 Typical High $630.96 | Professional | 54 · Surgery only | $204.17 | $630.96 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $125.89 Typical High $125.89 | Professional | 55 · Aftercare only | $40.74 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $83.18 Typical High $83.18 | Professional | 56 · Pre-op care only | $27.54 | $83.18 | $83.18 |
Where Montana sits
The same service costs 5.2 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $4,508MT $873
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.