How much rates vary
Facilitymedian $263 · 10th to 90th $257 to $1,047Professionalmedian $263 · 10th to 90th $155 to $324
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 $162.18 Median $323.59 Typical High $501.19 | Professional | None | $162.18 | $323.59 | $501.19 |
BCBS Montana Setting Professional Modifier None Typical Low $263.03 Median $263.03 Typical High $263.03 | Professional | None | $263.03 | $263.03 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $263.03 Median $1,047.13 Typical High $3,019.95 | Facility | None | $263.03 | $1,047.13 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $234.42 Median $263.03 Typical High $323.59 | Professional | None | $234.42 | $263.03 | $323.59 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $257.04 Median $263.03 Typical High $346.74 | Facility | None | $257.04 | $263.03 | $346.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $165.96 Median $257.04 Typical High $275.42 | Professional | None | $165.96 | $257.04 | $275.42 |
Providence Setting Facility Modifier None Typical Low $263.03 Median $1,047.13 Typical High $3,019.95 | Facility | None | $263.03 | $1,047.13 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $239.88 Typical High $288.40 | Professional | None | $79.43 | $239.88 | $288.40 |
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 $245.47 Median $288.40 Typical High $398.11 | Professional | None | $245.47 | $288.40 | $398.11 |
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 $81.28 Median $251.19 Typical High $251.19 | Professional | 52 · Reduced service | $81.28 | $251.19 | $251.19 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $100.00 Typical High $100.00 | Professional | 53 · Discontinued | $32.36 | $100.00 | $100.00 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $120.23 Median $371.54 Typical High $371.54 | Professional | 54 · Surgery only | $120.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $24.55 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $50.12 Typical High $50.12 | Professional | 56 · Pre-op care only | $16.22 | $50.12 | $50.12 |
Where Montana sits
The same service costs 7.7 times more in Colorado than in Montana. 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.
Physician feeFacility fee
CO $4,047MT $526
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.