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 $389.05 Median $1,202.26 Typical High $1,202.26 | Professional | None | $389.05 | $1,202.26 | $1,202.26 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $7,413.10 Typical High $12,882.50 | Facility | None | $630.96 | $7,413.10 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $436.52 Median $630.96 Typical High $707.95 | Professional | None | $436.52 | $630.96 | $707.95 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $616.60 Median $616.60 Typical High $707.95 | Facility | None | $616.60 | $616.60 | $707.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $660.69 | Professional | None | $398.11 | $616.60 | $660.69 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $7,413.10 Typical High $12,882.50 | Facility | None | $630.96 | $7,413.10 | $12,882.50 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $575.44 Typical High $645.65 | Professional | None | $79.43 | $575.44 | $645.65 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $2,884.03 Typical High $4,570.88 | Facility | None | $1,479.11 | $2,884.03 | $4,570.88 |
United Setting Professional Modifier None Typical Low $588.84 Median $691.83 Typical High $812.83 | Professional | None | $588.84 | $691.83 | $812.83 |
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 $194.98 Median $602.56 Typical High $602.56 | Professional | 52 · Reduced service | $194.98 | $602.56 | $602.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $77.62 Median $239.88 Typical High $239.88 | Professional | 53 · Discontinued | $77.62 | $239.88 | $239.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $295.12 Median $891.25 Typical High $891.25 | Professional | 54 · Surgery only | $295.12 | $891.25 | $891.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $58.88 Median $181.97 Typical High $181.97 | Professional | 55 · Aftercare only | $58.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.90 Median $120.23 Typical High $120.23 | Professional | 56 · Pre-op care only | $38.90 | $120.23 | $120.23 |
Where Montana sits
The same service costs 4.5 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· 17th of 51
$631
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.