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 $346.74 Median $1,096.48 Typical High $1,096.48 | Professional | None | $346.74 | $1,096.48 | $1,096.48 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Cigna Setting Professional Modifier None Typical Low $501.19 Median $602.56 Typical High $645.65 | Professional | None | $501.19 | $602.56 | $645.65 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $549.54 Median $588.84 Typical High $676.08 | Facility | None | $549.54 | $588.84 | $676.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $630.96 | Professional | None | $380.19 | $588.84 | $630.96 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $602.56 Typical High $602.56 | Facility | None | $602.56 | $602.56 | $602.56 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $549.54 Typical High $616.60 | Professional | None | $79.43 | $549.54 | $616.60 |
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 $549.54 Median $645.65 Typical High $758.58 | Professional | None | $549.54 | $645.65 | $758.58 |
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 $263.03 Median $812.83 Typical High $812.83 | Professional | 54 · Surgery only | $263.03 | $812.83 | $812.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $52.48 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $109.65 Typical High $109.65 | Professional | 56 · Pre-op care only | $34.67 | $109.65 | $109.65 |
Where Montana sits
The same service costs 4.4 times more in Alaska than in New Jersey. 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
$603
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.