How much rates vary
Facilitymedian $316 · 10th to 90th $117 to $617Professionalmedian $191 · 10th to 90th $79 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 $69.18 Median $218.78 Typical High $831.76 | Professional | None | $69.18 | $218.78 | $831.76 |
BCBS Montana Setting Facility Modifier None Typical Low $281.84 Median $281.84 Typical High $281.84 | Facility | None | $281.84 | $281.84 | $281.84 |
BCBS Montana Setting Professional Modifier None Typical Low $117.49 Median $117.49 Typical High $446.68 | Professional | None | $117.49 | $117.49 | $446.68 |
Cigna Setting Facility Modifier None Typical Low $117.49 Median $426.58 Typical High $3,019.95 | Facility | None | $117.49 | $426.58 | $3,019.95 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $234.42 Typical High $446.68 | Professional | None | $112.20 | $234.42 | $446.68 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $120.23 Median $154.88 Typical High $575.44 | Facility | None | $120.23 | $154.88 | $575.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $79.43 Median $147.91 Typical High $562.34 | Professional | None | $79.43 | $147.91 | $562.34 |
Providence Setting Facility Modifier None Typical Low $117.49 Median $426.58 Typical High $3,019.95 | Facility | None | $117.49 | $426.58 | $3,019.95 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $467.74 | Professional | None | $79.43 | $120.23 | $467.74 |
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 $117.49 Median $275.42 Typical High $467.74 | Professional | None | $117.49 | $275.42 | $467.74 |
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 $37.15 Median $109.65 Typical High $416.87 | Professional | 52 · Reduced service | $37.15 | $109.65 | $416.87 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $43.65 Typical High $165.96 | Professional | 53 · Discontinued | $14.79 | $43.65 | $165.96 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $56.23 Median $162.18 Typical High $630.96 | Professional | 54 · Surgery only | $56.23 | $162.18 | $630.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.22 Median $32.36 Typical High $125.89 | Professional | 55 · Aftercare only | $11.22 | $32.36 | $125.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $21.88 Typical High $83.18 | Professional | 56 · Pre-op care only | $7.41 | $21.88 | $83.18 |
Where Montana sits
The same service costs 9.0 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 $4,579MT $507
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.