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 $616.60 Median $1,949.84 Typical High $1,949.84 | Professional | None | $616.60 | $1,949.84 | $1,949.84 |
Cigna Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $1,071.52 Typical High $1,096.48 | Professional | None | $691.83 | $1,071.52 | $1,096.48 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $851.14 Median $1,122.02 Typical High $1,288.25 | Facility | None | $851.14 | $1,122.02 | $1,288.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $741.31 Median $1,122.02 Typical High $1,202.26 | Professional | None | $741.31 | $1,122.02 | $1,202.26 |
Providence Setting Facility Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Facility | None | $1,071.52 | $1,071.52 | $1,071.52 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $977.24 Typical High $1,096.48 | Professional | None | $79.43 | $977.24 | $1,096.48 |
United Setting Facility Modifier None Typical Low $602.56 Median $954.99 Typical High $1,862.09 | Facility | None | $602.56 | $954.99 | $1,862.09 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,288.25 | Professional | None | $912.01 | $1,071.52 | $1,288.25 |
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 $309.03 Median $954.99 Typical High $954.99 | Professional | 52 · Reduced service | $309.03 | $954.99 | $954.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $125.89 Median $389.05 Typical High $389.05 | Professional | 53 · Discontinued | $125.89 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $467.74 Median $1,445.44 Typical High $1,445.44 | Professional | 54 · Surgery only | $467.74 | $1,445.44 | $1,445.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $93.33 Median $288.40 Typical High $288.40 | Professional | 55 · Aftercare only | $93.33 | $288.40 | $288.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $61.66 Median $194.98 Typical High $194.98 | Professional | 56 · Pre-op care only | $61.66 | $194.98 | $194.98 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $436.52 Median $1,348.96 Typical High $1,348.96 | Professional | 78 · Unplanned return to OR | $436.52 | $1,348.96 | $1,348.96 |
Where Montana sits
The same service costs 5.4 times more in Alaska than in Texas. 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· 14th of 51
$1,072
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.