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 $85.11 Median $457.09 Typical High $2,818.38 | Professional | None | $85.11 | $457.09 | $2,818.38 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $1,047.13 Typical High $3,019.95 | Facility | None | $134.90 | $1,047.13 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $288.40 Typical High $1,479.11 | Professional | None | $131.83 | $288.40 | $1,479.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $138.04 Median $173.78 Typical High $1,905.46 | Facility | None | $138.04 | $173.78 | $1,905.46 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $1,862.09 | Professional | None | $89.13 | $169.82 | $1,862.09 |
Providence Setting Facility Modifier None Typical Low $134.90 Median $1,047.13 Typical High $3,019.95 | Facility | None | $134.90 | $1,047.13 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $1,584.89 | Professional | None | $79.43 | $134.90 | $1,584.89 |
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 $131.83 Median $354.81 Typical High $1,737.80 | Professional | None | $131.83 | $354.81 | $1,737.80 |
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 $41.69 Median $229.09 Typical High $1,412.54 | Professional | 52 · Reduced service | $41.69 | $229.09 | $1,412.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $91.20 Typical High $575.44 | Professional | 53 · Discontinued | $16.98 | $91.20 | $575.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $63.10 Median $338.84 Typical High $2,137.96 | Professional | 54 · Surgery only | $63.10 | $338.84 | $2,137.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $67.61 Typical High $426.58 | Professional | 55 · Aftercare only | $12.59 | $67.61 | $426.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $45.71 Typical High $281.84 | Professional | 56 · Pre-op care only | $8.51 | $45.71 | $281.84 |
Where Montana sits
The same service costs 14.1 times more in Washington than in Kentucky. 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· 45th of 51
$224
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.