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 $331.13 Typical High $331.13 | Professional | None | $107.15 | $331.13 | $331.13 |
Cigna Setting Facility Modifier None Typical Low $181.97 Median $7,079.46 Typical High $12,882.50 | Facility | None | $181.97 | $7,079.46 | $12,882.50 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $275.42 | Professional | None | $154.88 | $181.97 | $275.42 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $173.78 Median $186.21 Typical High $213.80 | Facility | None | $173.78 | $186.21 | $213.80 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $120.23 Median $186.21 Typical High $199.53 | Professional | None | $120.23 | $186.21 | $199.53 |
Providence Setting Facility Modifier None Typical Low $181.97 Median $7,079.46 Typical High $12,882.50 | Facility | None | $181.97 | $7,079.46 | $12,882.50 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $169.82 Typical High $186.21 | Professional | None | $79.43 | $169.82 | $186.21 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $2,884.03 Typical High $4,570.88 | Facility | None | $1,479.11 | $2,884.03 | $4,570.88 |
United Setting Professional Modifier None Typical Low $165.96 Median $199.53 Typical High $234.42 | Professional | None | $165.96 | $199.53 | $234.42 |
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 $53.70 Median $165.96 Typical High $165.96 | Professional | 52 · Reduced service | $53.70 | $165.96 | $165.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.88 Median $66.07 Typical High $66.07 | Professional | 53 · Discontinued | $21.88 | $66.07 | $66.07 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $81.28 Median $251.19 Typical High $251.19 | Professional | 54 · Surgery only | $81.28 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $50.12 Typical High $50.12 | Professional | 55 · Aftercare only | $16.22 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $33.11 Typical High $33.11 | Professional | 56 · Pre-op care only | $10.72 | $33.11 | $33.11 |
Where Montana sits
The same service costs 4.8 times more in Alaska than in Utah. 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· 16th of 51
$182
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.