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 $107.15 Median $234.42 Typical High $645.65 | Professional | None | $107.15 | $234.42 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $173.78 Median $1,047.13 Typical High $3,019.95 | Facility | None | $173.78 | $1,047.13 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $234.42 Typical High $346.74 | Professional | None | $169.82 | $234.42 | $346.74 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $173.78 Median $218.78 Typical High $446.68 | Facility | None | $173.78 | $218.78 | $446.68 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $112.20 Median $213.80 Typical High $436.52 | Professional | None | $112.20 | $213.80 | $436.52 |
Providence Setting Facility Modifier None Typical Low $173.78 Median $1,047.13 Typical High $3,019.95 | Facility | None | $173.78 | $1,047.13 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $173.78 Typical High $363.08 | Professional | None | $79.43 | $173.78 | $363.08 |
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 $173.78 Median $269.15 Typical High $380.19 | Professional | None | $173.78 | $269.15 | $380.19 |
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 $54.95 Median $162.18 Typical High $323.59 | Professional | 52 · Reduced service | $54.95 | $162.18 | $323.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $64.57 Typical High $131.83 | Professional | 53 · Discontinued | $21.88 | $64.57 | $131.83 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $239.88 Typical High $489.78 | Professional | 54 · Surgery only | $81.28 | $239.88 | $489.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $47.86 Typical High $97.72 | Professional | 55 · Aftercare only | $16.60 | $47.86 | $97.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.96 Median $32.36 Typical High $64.57 | Professional | 56 · Pre-op care only | $10.96 | $32.36 | $64.57 |
Where Montana sits
The same service costs 3.8 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· 24th of 51
$219
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.