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 $81.28 Median $223.87 Typical High $602.56 | Professional | None | $81.28 | $223.87 | $602.56 |
Cigna Setting Facility Modifier None Typical Low $134.90 Median $2,290.87 Typical High $6,606.93 | Facility | None | $134.90 | $2,290.87 | $6,606.93 |
Cigna Setting Professional Modifier None Typical Low $128.82 Median $213.80 Typical High $323.59 | Professional | None | $128.82 | $213.80 | $323.59 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $138.04 Median $173.78 Typical High $416.87 | Facility | None | $138.04 | $173.78 | $416.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $89.13 Median $169.82 Typical High $416.87 | Professional | None | $89.13 | $169.82 | $416.87 |
Providence Setting Facility Modifier None Typical Low $134.90 Median $2,290.87 Typical High $6,606.93 | Facility | None | $134.90 | $2,290.87 | $6,606.93 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $338.84 | Professional | None | $79.43 | $134.90 | $338.84 |
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 $234.42 Typical High $338.84 | Professional | None | $131.83 | $234.42 | $338.84 |
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 $40.74 Median $120.23 Typical High $302.00 | Professional | 52 · Reduced service | $40.74 | $120.23 | $302.00 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.60 Median $47.86 Typical High $120.23 | Professional | 53 · Discontinued | $16.60 | $47.86 | $120.23 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $61.66 Median $181.97 Typical High $446.68 | Professional | 54 · Surgery only | $61.66 | $181.97 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $36.31 Typical High $91.20 | Professional | 55 · Aftercare only | $12.30 | $36.31 | $91.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $23.99 Typical High $60.26 | Professional | 56 · Pre-op care only | $8.13 | $23.99 | $60.26 |
Where Montana sits
The same service costs 4.5 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· 23rd of 51
$191
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.