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 $95.50 Median $288.40 Typical High $630.96 | Professional | None | $95.50 | $288.40 | $630.96 |
Cigna Setting Facility Modifier None Typical Low $158.49 Median $2,290.87 Typical High $6,606.93 | Facility | None | $158.49 | $2,290.87 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $147.91 Median $223.87 Typical High $338.84 | Professional | None | $147.91 | $223.87 | $338.84 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $162.18 Median $208.93 Typical High $436.52 | Facility | None | $162.18 | $208.93 | $436.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $104.71 Median $199.53 Typical High $436.52 | Professional | None | $104.71 | $199.53 | $436.52 |
Providence Setting Facility Modifier None Typical Low $158.49 Median $2,290.87 Typical High $6,606.93 | Facility | None | $158.49 | $2,290.87 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $354.81 | Professional | None | $79.43 | $162.18 | $354.81 |
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 $151.36 Median $239.88 Typical High $354.81 | Professional | None | $151.36 | $239.88 | $354.81 |
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 $47.86 Median $144.54 Typical High $316.23 | Professional | 52 · Reduced service | $47.86 | $144.54 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $57.54 Typical High $125.89 | Professional | 53 · Discontinued | $19.50 | $57.54 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $72.44 Median $213.80 Typical High $467.74 | Professional | 54 · Surgery only | $72.44 | $213.80 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $42.66 Typical High $95.50 | Professional | 55 · Aftercare only | $14.45 | $42.66 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $28.84 Typical High $63.10 | Professional | 56 · Pre-op care only | $9.55 | $28.84 | $63.10 |
Where Montana sits
The same service costs 4.0 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· 21st of 51
$214
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.