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 $1,174.90 Median $3,630.78 Typical High $3,630.78 | Professional | None | $1,174.90 | $3,630.78 | $3,630.78 |
Cigna Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Cigna Setting Professional Modifier None Typical Low $1,318.26 Median $1,995.26 Typical High $2,137.96 | Professional | None | $1,318.26 | $1,995.26 | $2,137.96 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,819.70 Median $2,041.74 Typical High $2,344.23 | Facility | None | $1,819.70 | $2,041.74 | $2,344.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,318.26 Median $2,041.74 Typical High $2,187.76 | Professional | None | $1,318.26 | $2,041.74 | $2,187.76 |
Providence Setting Facility Modifier None Typical Low $1,995.26 Median $1,995.26 Typical High $1,995.26 | Facility | None | $1,995.26 | $1,995.26 | $1,995.26 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,862.09 Typical High $2,041.74 | Professional | None | $79.43 | $1,862.09 | $2,041.74 |
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 $1,778.28 Median $2,089.30 Typical High $2,511.89 | Professional | None | $1,778.28 | $2,089.30 | $2,511.89 |
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 $588.84 Median $1,819.70 Typical High $1,819.70 | Professional | 52 · Reduced service | $588.84 | $1,819.70 | $1,819.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $234.42 Median $724.44 Typical High $724.44 | Professional | 53 · Discontinued | $234.42 | $724.44 | $724.44 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $870.96 Median $2,754.23 Typical High $2,754.23 | Professional | 54 · Surgery only | $870.96 | $2,754.23 | $2,754.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $173.78 Median $549.54 Typical High $549.54 | Professional | 55 · Aftercare only | $173.78 | $549.54 | $549.54 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $117.49 Median $363.08 Typical High $363.08 | Professional | 56 · Pre-op care only | $117.49 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $812.83 Median $2,570.40 Typical High $2,570.40 | Professional | 78 · Unplanned return to OR | $812.83 | $2,570.40 | $2,570.40 |
Where Montana sits
The same service costs 22.4 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
$1,995
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.