How much rates vary
Facilitymedian $380 · 10th to 90th $372 to $1,047Professionalmedian $389 · 10th to 90th $200 to $468
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 $229.09 Median $354.81 Typical High $741.31 | Professional | None | $229.09 | $354.81 | $741.31 |
BCBS Montana Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
Cigna Setting Facility Modifier None Typical Low $389.05 Median $1,047.13 Typical High $3,019.95 | Facility | None | $389.05 | $1,047.13 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $389.05 Typical High $436.52 | Professional | None | $288.40 | $389.05 | $436.52 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $371.54 Median $380.19 Typical High $436.52 | Facility | None | $371.54 | $380.19 | $436.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $239.88 Median $371.54 Typical High $398.11 | Professional | None | $239.88 | $371.54 | $398.11 |
Providence Setting Facility Modifier None Typical Low $389.05 Median $1,047.13 Typical High $3,019.95 | Facility | None | $389.05 | $1,047.13 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $363.08 Typical High $398.11 | Professional | None | $79.43 | $363.08 | $398.11 |
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 $363.08 Median $426.58 Typical High $501.19 | Professional | None | $363.08 | $426.58 | $501.19 |
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 $123.03 Median $371.54 Typical High $371.54 | Professional | 52 · Reduced service | $123.03 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $147.91 Typical High $147.91 | Professional | 53 · Discontinued | $48.98 | $147.91 | $147.91 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $169.82 Median $549.54 Typical High $549.54 | Professional | 54 · Surgery only | $169.82 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $112.20 Typical High $112.20 | Professional | 55 · Aftercare only | $36.31 | $112.20 | $112.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $74.13 Typical High $74.13 | Professional | 56 · Pre-op care only | $24.55 | $74.13 | $74.13 |
Where Montana sits
The same service costs 5.6 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 $4,320MT $769
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.