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 $724.44 Median $2,238.72 Typical High $2,238.72 | Professional | None | $724.44 | $2,238.72 | $2,238.72 |
Cigna Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Cigna Setting Professional Modifier None Typical Low $812.83 Median $1,230.27 Typical High $1,318.26 | Professional | None | $812.83 | $1,230.27 | $1,318.26 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,096.48 Median $1,258.93 Typical High $1,445.44 | Facility | None | $1,096.48 | $1,258.93 | $1,445.44 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $812.83 Median $1,258.93 Typical High $1,348.96 | Professional | None | $812.83 | $1,258.93 | $1,348.96 |
Providence Setting Facility Modifier None Typical Low $1,230.27 Median $1,230.27 Typical High $1,230.27 | Facility | None | $1,230.27 | $1,230.27 | $1,230.27 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,122.02 Typical High $1,258.93 | Professional | None | $79.43 | $1,122.02 | $1,258.93 |
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 $1,096.48 Median $1,288.25 Typical High $1,513.56 | Professional | None | $1,096.48 | $1,288.25 | $1,513.56 |
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 $354.81 Median $1,122.02 Typical High $1,122.02 | Professional | 52 · Reduced service | $354.81 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $144.54 Median $446.68 Typical High $446.68 | Professional | 53 · Discontinued | $144.54 | $446.68 | $446.68 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $537.03 Median $1,659.59 Typical High $1,659.59 | Professional | 54 · Surgery only | $537.03 | $1,659.59 | $1,659.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $107.15 Median $331.13 Typical High $331.13 | Professional | 55 · Aftercare only | $107.15 | $331.13 | $331.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $72.44 Median $223.87 Typical High $223.87 | Professional | 56 · Pre-op care only | $72.44 | $223.87 | $223.87 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $501.19 Median $1,548.82 Typical High $1,548.82 | Professional | 78 · Unplanned return to OR | $501.19 | $1,548.82 | $1,548.82 |
Where Montana sits
The same service costs 5.9 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
$1,230
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.