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 $125.89 Median $223.87 Typical High $691.83 | Professional | None | $125.89 | $223.87 | $691.83 |
BCBS Montana Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $380.19 | Professional | None | $218.78 | $218.78 | $380.19 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $1,023.29 | Facility | None | $218.78 | $323.59 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $257.04 Typical High $380.19 | Professional | None | $194.98 | $257.04 | $380.19 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $223.87 Median $275.42 Typical High $501.19 | Facility | None | $223.87 | $275.42 | $501.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $144.54 Median $275.42 Typical High $489.78 | Professional | None | $144.54 | $275.42 | $489.78 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $323.59 Typical High $1,023.29 | Facility | None | $218.78 | $323.59 | $1,023.29 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $389.05 | Professional | None | $79.43 | $218.78 | $389.05 |
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 $213.80 Median $295.12 Typical High $426.58 | Professional | None | $213.80 | $295.12 | $426.58 |
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 $66.07 Median $199.53 Typical High $346.74 | Professional | 52 · Reduced service | $66.07 | $199.53 | $346.74 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $79.43 Typical High $138.04 | Professional | 53 · Discontinued | $26.92 | $79.43 | $138.04 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $100.00 Median $302.00 Typical High $524.81 | Professional | 54 · Surgery only | $100.00 | $302.00 | $524.81 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $60.26 Typical High $104.71 | Professional | 55 · Aftercare only | $19.95 | $60.26 | $104.71 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $39.81 Typical High $69.18 | Professional | 56 · Pre-op care only | $13.18 | $39.81 | $69.18 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $93.33 Median $281.84 Typical High $489.78 | Professional | 78 · Unplanned return to OR | $93.33 | $281.84 | $489.78 |
Where Montana sits
The same service costs 3.5 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· 26th of 51
$245
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.