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 $87.10 Median $251.19 Typical High $616.60 | Professional | None | $87.10 | $251.19 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $1,047.13 Typical High $3,019.95 | Facility | None | $141.25 | $1,047.13 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $218.78 Typical High $331.13 | Professional | None | $138.04 | $218.78 | $331.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $147.91 Median $186.21 Typical High $436.52 | Facility | None | $147.91 | $186.21 | $436.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $95.50 Median $181.97 Typical High $426.58 | Professional | None | $95.50 | $181.97 | $426.58 |
Providence Setting Facility Modifier None Typical Low $141.25 Median $1,047.13 Typical High $3,019.95 | Facility | None | $141.25 | $1,047.13 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $141.25 Typical High $346.74 | Professional | None | $79.43 | $141.25 | $346.74 |
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 $141.25 Median $245.47 Typical High $354.81 | Professional | None | $141.25 | $245.47 | $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 $43.65 Median $125.89 Typical High $309.03 | Professional | 52 · Reduced service | $43.65 | $125.89 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $51.29 Typical High $123.03 | Professional | 53 · Discontinued | $17.38 | $51.29 | $123.03 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $66.07 Median $190.55 Typical High $467.74 | Professional | 54 · Surgery only | $66.07 | $190.55 | $467.74 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $38.02 Typical High $93.33 | Professional | 55 · Aftercare only | $13.18 | $38.02 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $25.70 Typical High $61.66 | Professional | 56 · Pre-op care only | $8.71 | $25.70 | $61.66 |
Where Montana sits
The same service costs 4.2 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· 22nd of 51
$209
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.