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 $245.47 Median $776.25 Typical High $776.25 | Professional | None | $245.47 | $776.25 | $776.25 |
Cigna Setting Facility Modifier None Typical Low $407.38 Median $7,762.47 Typical High $12,882.50 | Facility | None | $407.38 | $7,762.47 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $407.38 Typical High $446.68 | Professional | None | $302.00 | $407.38 | $446.68 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $389.05 Median $398.11 Typical High $457.09 | Facility | None | $389.05 | $398.11 | $457.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $251.19 Median $389.05 Typical High $416.87 | Professional | None | $251.19 | $389.05 | $416.87 |
Providence Setting Facility Modifier None Typical Low $407.38 Median $7,762.47 Typical High $12,882.50 | Facility | None | $407.38 | $7,762.47 | $12,882.50 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $371.54 Typical High $416.87 | Professional | None | $79.43 | $371.54 | $416.87 |
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 $380.19 Median $446.68 Typical High $512.86 | Professional | None | $380.19 | $446.68 | $512.86 |
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 $123.03 Median $380.19 Typical High $380.19 | Professional | 52 · Reduced service | $123.03 | $380.19 | $380.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $50.12 Median $154.88 Typical High $154.88 | Professional | 53 · Discontinued | $50.12 | $154.88 | $154.88 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $177.83 Median $575.44 Typical High $575.44 | Professional | 54 · Surgery only | $177.83 | $575.44 | $575.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $37.15 Median $114.82 Typical High $114.82 | Professional | 55 · Aftercare only | $37.15 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $77.62 Typical High $77.62 | Professional | 56 · Pre-op care only | $24.55 | $77.62 | $77.62 |
Where Montana sits
The same service costs 4.3 times more in Alaska than in Florida. 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· 18th of 51
$407
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.