How much rates vary
Facilitymedian $437 · 10th to 90th $427 to $5,370Professionalmedian $427 · 10th to 90th $79 to $513
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 $275.42 Median $812.83 Typical High $812.83 | Professional | None | $275.42 | $812.83 | $812.83 |
Cigna Setting Facility Modifier None Typical Low $426.58 Median $5,370.32 Typical High $15,488.17 | Facility | None | $426.58 | $5,370.32 | $15,488.17 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $426.58 Typical High $512.86 | Professional | None | $323.59 | $426.58 | $512.86 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $426.58 Median $436.52 Typical High $501.19 | Facility | None | $426.58 | $436.52 | $501.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $281.84 Median $426.58 Typical High $457.09 | Professional | None | $281.84 | $426.58 | $457.09 |
Providence Setting Facility Modifier None Typical Low $426.58 Median $5,370.32 Typical High $15,488.17 | Facility | None | $426.58 | $5,370.32 | $15,488.17 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $389.05 Typical High $436.52 | Professional | None | $79.43 | $389.05 | $436.52 |
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 $398.11 Median $478.63 Typical High $562.34 | Professional | None | $398.11 | $478.63 | $562.34 |
5 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 $138.04 Median $407.38 Typical High $407.38 | Professional | 52 · Reduced service | $138.04 | $407.38 | $407.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $54.95 Median $162.18 Typical High $162.18 | Professional | 53 · Discontinued | $54.95 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $204.17 Median $616.60 Typical High $616.60 | Professional | 54 · Surgery only | $204.17 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $40.74 Median $123.03 Typical High $123.03 | Professional | 55 · Aftercare only | $40.74 | $123.03 | $123.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $27.54 Median $81.28 Typical High $81.28 | Professional | 56 · Pre-op care only | $27.54 | $81.28 | $81.28 |
Where Montana sits
The same service costs 10.4 times more in Wyoming than in Montana. 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
WY $8,979MT $863
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.