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 $977.24 Median $3,019.95 Typical High $3,019.95 | Professional | None | $977.24 | $3,019.95 | $3,019.95 |
Cigna Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Cigna Setting Professional Modifier None Typical Low $1,096.48 Median $1,659.59 Typical High $1,778.28 | Professional | None | $1,096.48 | $1,659.59 | $1,778.28 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,479.11 Median $1,737.80 Typical High $1,995.26 | Facility | None | $1,479.11 | $1,737.80 | $1,995.26 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,122.02 Median $1,737.80 Typical High $1,862.09 | Professional | None | $1,122.02 | $1,737.80 | $1,862.09 |
Providence Setting Facility Modifier None Typical Low $1,659.59 Median $1,659.59 Typical High $1,659.59 | Facility | None | $1,659.59 | $1,659.59 | $1,659.59 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,548.82 Typical High $1,698.24 | Professional | None | $79.43 | $1,548.82 | $1,698.24 |
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 $1,479.11 Median $1,737.80 Typical High $2,041.74 | Professional | None | $1,479.11 | $1,737.80 | $2,041.74 |
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 $489.78 Median $1,513.56 Typical High $1,513.56 | Professional | 52 · Reduced service | $489.78 | $1,513.56 | $1,513.56 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $194.98 Median $616.60 Typical High $616.60 | Professional | 53 · Discontinued | $194.98 | $616.60 | $616.60 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $724.44 Median $2,290.87 Typical High $2,290.87 | Professional | 54 · Surgery only | $724.44 | $2,290.87 | $2,290.87 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $147.91 Median $457.09 Typical High $457.09 | Professional | 55 · Aftercare only | $147.91 | $457.09 | $457.09 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $97.72 Median $302.00 Typical High $302.00 | Professional | 56 · Pre-op care only | $97.72 | $302.00 | $302.00 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $676.08 Median $2,137.96 Typical High $2,137.96 | Professional | 78 · Unplanned return to OR | $676.08 | $2,137.96 | $2,137.96 |
Where Montana sits
The same service costs 24.5 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· 14th of 51
$1,660
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.