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 $1,071.52 Typical High $1,071.52 | Professional | None | $346.74 | $1,071.52 | $1,071.52 |
Cigna Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $6,606.93 | Facility | None | $602.56 | $2,290.87 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $389.05 Median $602.56 Typical High $616.60 | Professional | None | $389.05 | $602.56 | $616.60 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $524.81 Median $630.96 Typical High $724.44 | Facility | None | $524.81 | $630.96 | $724.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $407.38 Median $630.96 Typical High $676.08 | Professional | None | $407.38 | $630.96 | $676.08 |
Providence Setting Facility Modifier None Typical Low $602.56 Median $2,290.87 Typical High $6,606.93 | Facility | None | $602.56 | $2,290.87 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $537.03 Typical High $602.56 | Professional | None | $79.43 | $537.03 | $602.56 |
United Setting Facility Modifier None Typical Low $1,445.44 Median $2,238.72 Typical High $3,162.28 | Facility | None | $1,445.44 | $2,238.72 | $3,162.28 |
United Setting Professional Modifier None Typical Low $524.81 Median $602.56 Typical High $724.44 | Professional | None | $524.81 | $602.56 | $724.44 |
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 $173.78 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $173.78 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $69.18 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $69.18 | $213.80 | $213.80 |
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 $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $34.67 | $107.15 | $107.15 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $245.47 Median $758.58 Typical High $758.58 | Professional | 78 · Unplanned return to OR | $245.47 | $758.58 | $758.58 |
Where Montana sits
The same service costs 5.1 times more in Alaska than in Utah. 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
$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.