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 $354.81 Median $602.56 Typical High $1,047.13 | Professional | None | $354.81 | $602.56 | $1,047.13 |
Cigna Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Cigna Setting Professional Modifier None Typical Low $537.03 Median $575.44 Typical High $645.65 | Professional | None | $537.03 | $575.44 | $645.65 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $588.84 Median $602.56 Typical High $691.83 | Facility | None | $588.84 | $602.56 | $691.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $380.19 Median $588.84 Typical High $630.96 | Professional | None | $380.19 | $588.84 | $630.96 |
Providence Setting Facility Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Facility | None | $575.44 | $575.44 | $575.44 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $524.81 Typical High $588.84 | Professional | None | $79.43 | $524.81 | $588.84 |
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 $467.74 Median $537.03 Typical High $645.65 | Professional | None | $467.74 | $537.03 | $645.65 |
3 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 54 · Surgery only Typical Low $269.15 Median $794.33 Typical High $794.33 | Professional | 54 · Surgery only | $269.15 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $53.70 Median $158.49 Typical High $158.49 | Professional | 55 · Aftercare only | $53.70 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $35.48 Median $104.71 Typical High $104.71 | Professional | 56 · Pre-op care only | $35.48 | $104.71 | $104.71 |
Where Montana sits
The same service costs 15.1 times more in New York than in Hawaii. 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· 17th of 51
$575
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.