How much rates vary
Facilitymedian $5,754 · 10th to 90th $692 to $11,749Professionalmedian $1,023 · 10th to 90th $457 to $11,220
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 $446.68 Median $2,454.71 Typical High $17,782.79 | Professional | None | $446.68 | $2,454.71 | $17,782.79 |
BCBS Montana Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $9,120.11 | Professional | None | $691.83 | $691.83 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $12,302.69 Typical High $23,442.29 | Facility | None | $691.83 | $12,302.69 | $23,442.29 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $1,318.26 Typical High $9,120.11 | Professional | None | $630.96 | $1,318.26 | $9,120.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $691.83 Median $870.96 Typical High $10,715.19 | Facility | None | $691.83 | $870.96 | $10,715.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $446.68 Median $851.14 Typical High $10,715.19 | Professional | None | $446.68 | $851.14 | $10,715.19 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $12,302.69 Typical High $23,442.29 | Facility | None | $691.83 | $12,302.69 | $23,442.29 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $691.83 Typical High $10,000.00 | Professional | None | $79.43 | $691.83 | $10,000.00 |
United Setting Facility Modifier None Typical Low $2,691.53 Median $3,311.31 Typical High $9,120.11 | Facility | None | $2,691.53 | $3,311.31 | $9,120.11 |
United Setting Professional Modifier None Typical Low $724.44 Median $5,248.07 Typical High $12,302.69 | Professional | None | $724.44 | $5,248.07 | $12,302.69 |
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 $223.87 Median $1,230.27 Typical High $8,912.51 | Professional | 52 · Reduced service | $223.87 | $1,230.27 | $8,912.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $89.13 Median $489.78 Typical High $3,548.13 | Professional | 53 · Discontinued | $89.13 | $489.78 | $3,548.13 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $323.59 Median $1,862.09 Typical High $13,489.63 | Professional | 54 · Surgery only | $323.59 | $1,862.09 | $13,489.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $66.07 Median $371.54 Typical High $2,691.53 | Professional | 55 · Aftercare only | $66.07 | $371.54 | $2,691.53 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $44.67 Median $245.47 Typical High $1,778.28 | Professional | 56 · Pre-op care only | $44.67 | $245.47 | $1,778.28 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $309.03 Median $1,737.80 Typical High $12,589.25 | Professional | 78 · Unplanned return to OR | $309.03 | $1,737.80 | $12,589.25 |
Where Montana sits
The same service costs 4.1 times more in Iowa than in Delaware. 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
IA $18,453DE $4,539
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.