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 $1,258.93 Median $3,890.45 Typical High $3,890.45 | Professional | None | $1,258.93 | $3,890.45 | $3,890.45 |
Cigna Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Cigna Setting Professional Modifier None Typical Low $1,412.54 Median $2,137.96 Typical High $2,290.87 | Professional | None | $1,412.54 | $2,137.96 | $2,290.87 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,949.84 Median $2,187.76 Typical High $2,511.89 | Facility | None | $1,949.84 | $2,187.76 | $2,511.89 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,412.54 Median $2,187.76 Typical High $2,344.23 | Professional | None | $1,412.54 | $2,187.76 | $2,344.23 |
Providence Setting Facility Modifier None Typical Low $2,137.96 Median $2,137.96 Typical High $2,137.96 | Facility | None | $2,137.96 | $2,137.96 | $2,137.96 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,995.26 Typical High $2,187.76 | Professional | None | $79.43 | $1,995.26 | $2,187.76 |
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 $1,905.46 Median $2,290.87 Typical High $2,691.53 | Professional | None | $1,905.46 | $2,290.87 | $2,691.53 |
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 $630.96 Median $1,949.84 Typical High $1,949.84 | Professional | 52 · Reduced service | $630.96 | $1,949.84 | $1,949.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $794.33 Typical High $794.33 | Professional | 53 · Discontinued | $251.19 | $794.33 | $794.33 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $933.25 Median $2,951.21 Typical High $2,951.21 | Professional | 54 · Surgery only | $933.25 | $2,951.21 | $2,951.21 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $588.84 Typical High $588.84 | Professional | 55 · Aftercare only | $186.21 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $389.05 Typical High $389.05 | Professional | 56 · Pre-op care only | $125.89 | $389.05 | $389.05 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $870.96 Median $2,754.23 Typical High $2,754.23 | Professional | 78 · Unplanned return to OR | $870.96 | $2,754.23 | $2,754.23 |
Where Montana sits
The same service costs 5.2 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· 15th of 51
$2,138
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.