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 $36.31 Median $83.18 Typical High $354.81 | Professional | None | $36.31 | $83.18 | $354.81 |
BCBS Montana Setting Professional Modifier None Typical Low $64.57 Median $158.49 Typical High $186.21 | Professional | None | $64.57 | $158.49 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $117.49 Typical High $186.21 | Professional | None | $60.26 | $117.49 | $186.21 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $69.18 Median $87.10 Typical High $239.88 | Facility | None | $69.18 | $87.10 | $239.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $44.67 Median $85.11 Typical High $234.42 | Professional | None | $44.67 | $85.11 | $234.42 |
Providence Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $79.43 Typical High $199.53 | Professional | None | $54.95 | $79.43 | $199.53 |
United Setting Facility Modifier None Typical Low $186.21 Median $199.53 Typical High $524.81 | Facility | None | $186.21 | $199.53 | $524.81 |
United Setting Professional Modifier None Typical Low $61.66 Median $117.49 Typical High $186.21 | Professional | None | $61.66 | $117.49 | $186.21 |
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 $19.95 Median $58.88 Typical High $177.83 | Professional | 52 · Reduced service | $19.95 | $58.88 | $177.83 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.94 Median $23.44 Typical High $70.79 | Professional | 53 · Discontinued | $7.94 | $23.44 | $70.79 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $29.51 Median $89.13 Typical High $263.03 | Professional | 54 · Surgery only | $29.51 | $89.13 | $263.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.03 Median $17.78 Typical High $52.48 | Professional | 55 · Aftercare only | $6.03 | $17.78 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $11.75 Typical High $35.48 | Professional | 56 · Pre-op care only | $4.07 | $11.75 | $35.48 |
Where Montana sits
The same service costs 3.4 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· 32nd of 51
$87.10
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.