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 $47.86 Median $114.82 Typical High $380.19 | Professional | None | $47.86 | $114.82 | $380.19 |
BCBS Montana Setting Professional Modifier None Typical Low $75.86 Median $204.17 Typical High $204.17 | Professional | None | $75.86 | $204.17 | $204.17 |
Cigna Setting Facility Modifier None Typical Low $75.86 Median $190.55 Typical High $2,344.23 | Facility | None | $75.86 | $190.55 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $75.86 Median $134.90 Typical High $204.17 | Professional | None | $75.86 | $134.90 | $204.17 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $77.62 Median $97.72 Typical High $275.42 | Facility | None | $77.62 | $97.72 | $275.42 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $50.12 Median $95.50 Typical High $269.15 | Professional | None | $50.12 | $95.50 | $269.15 |
Providence Setting Facility Modifier None Typical Low $75.86 Median $190.55 Typical High $2,344.23 | Facility | None | $75.86 | $190.55 | $2,344.23 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $208.93 | Professional | None | $64.57 | $79.43 | $208.93 |
United Setting Facility Modifier None Typical Low $398.11 Median $616.60 Typical High $954.99 | Facility | None | $398.11 | $616.60 | $954.99 |
United Setting Professional Modifier None Typical Low $75.86 Median $141.25 Typical High $223.87 | Professional | None | $75.86 | $141.25 | $223.87 |
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 $23.99 Median $69.18 Typical High $190.55 | Professional | 52 · Reduced service | $23.99 | $69.18 | $190.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.55 Median $27.54 Typical High $75.86 | Professional | 53 · Discontinued | $9.55 | $27.54 | $75.86 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $35.48 Median $104.71 Typical High $281.84 | Professional | 54 · Surgery only | $35.48 | $104.71 | $281.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.24 Median $20.89 Typical High $56.23 | Professional | 55 · Aftercare only | $7.24 | $20.89 | $56.23 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.79 Median $13.80 Typical High $38.02 | Professional | 56 · Pre-op care only | $4.79 | $13.80 | $38.02 |
Where Montana sits
The same service costs 3.5 times more in Alaska than in Washington, DC. 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· 29th of 51
$112
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.