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 $117.49 Median $288.40 Typical High $933.25 | Professional | None | $117.49 | $288.40 | $933.25 |
BCBS Montana Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $489.78 | Professional | None | $288.40 | $288.40 | $489.78 |
Cigna Setting Facility Modifier None Typical Low $288.40 Median $478.63 Typical High $2,344.23 | Facility | None | $288.40 | $478.63 | $2,344.23 |
Cigna Setting Professional Modifier None Typical Low $208.93 Median $302.00 Typical High $489.78 | Professional | None | $208.93 | $302.00 | $489.78 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $331.13 Median $363.08 Typical High $660.69 | Facility | None | $331.13 | $363.08 | $660.69 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $213.80 Median $371.54 Typical High $660.69 | Professional | None | $213.80 | $371.54 | $660.69 |
Providence Setting Facility Modifier None Typical Low $288.40 Median $478.63 Typical High $2,344.23 | Facility | None | $288.40 | $478.63 | $2,344.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $302.00 Typical High $512.86 | Professional | None | $79.43 | $302.00 | $512.86 |
United Setting Facility Modifier None Typical Low $398.11 Median $616.60 Typical High $954.99 | Facility | None | $398.11 | $616.60 | $954.99 |
United Setting Professional Modifier None Typical Low $208.93 Median $331.13 Typical High $537.03 | Professional | None | $208.93 | $331.13 | $537.03 |
6 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 $85.11 Median $269.15 Typical High $467.74 | Professional | 52 · Reduced service | $85.11 | $269.15 | $467.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $33.88 Median $107.15 Typical High $186.21 | Professional | 53 · Discontinued | $33.88 | $107.15 | $186.21 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $128.82 Median $407.38 Typical High $691.83 | Professional | 54 · Surgery only | $128.82 | $407.38 | $691.83 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $25.70 Median $81.28 Typical High $138.04 | Professional | 55 · Aftercare only | $25.70 | $81.28 | $138.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.98 Median $53.70 Typical High $93.33 | Professional | 56 · Pre-op care only | $16.98 | $53.70 | $93.33 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $120.23 Median $380.19 Typical High $645.65 | Professional | 78 · Unplanned return to OR | $120.23 | $380.19 | $645.65 |
Where Montana sits
The same service costs 4.5 times more in Alaska than in Kentucky. 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· 18th of 51
$331
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.