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 $1,071.52 Median $3,311.31 Typical High $3,311.31 | Professional | None | $1,071.52 | $3,311.31 | $3,311.31 |
Cigna Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Cigna Setting Professional Modifier None Typical Low $1,202.26 Median $1,819.70 Typical High $1,949.84 | Professional | None | $1,202.26 | $1,819.70 | $1,949.84 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,621.81 Median $1,905.46 Typical High $2,187.76 | Facility | None | $1,621.81 | $1,905.46 | $2,187.76 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,230.27 Median $1,905.46 Typical High $1,995.26 | Professional | None | $1,230.27 | $1,905.46 | $1,995.26 |
Providence Setting Facility Modifier None Typical Low $1,819.70 Median $1,819.70 Typical High $1,819.70 | Facility | None | $1,819.70 | $1,819.70 | $1,819.70 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,698.24 Typical High $1,862.09 | Professional | None | $79.43 | $1,698.24 | $1,862.09 |
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 $1,621.81 Median $1,949.84 Typical High $2,290.87 | Professional | None | $1,621.81 | $1,949.84 | $2,290.87 |
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 $537.03 Median $1,659.59 Typical High $1,659.59 | Professional | 52 · Reduced service | $537.03 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $213.80 Median $676.08 Typical High $676.08 | Professional | 53 · Discontinued | $213.80 | $676.08 | $676.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $812.83 Median $2,511.89 Typical High $2,511.89 | Professional | 54 · Surgery only | $812.83 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $162.18 Median $501.19 Typical High $501.19 | Professional | 55 · Aftercare only | $162.18 | $501.19 | $501.19 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $107.15 Median $331.13 Typical High $331.13 | Professional | 56 · Pre-op care only | $107.15 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $758.58 Median $2,344.23 Typical High $2,344.23 | Professional | 78 · Unplanned return to OR | $758.58 | $2,344.23 | $2,344.23 |
Where Montana sits
The same service costs 5.5 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
$1,820
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.