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 $2,089.30 Median $6,606.93 Typical High $6,606.93 | Professional | None | $2,089.30 | $6,606.93 | $6,606.93 |
Cigna Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Cigna Setting Professional Modifier None Typical Low $2,398.83 Median $3,630.78 Typical High $3,890.45 | Professional | None | $2,398.83 | $3,630.78 | $3,890.45 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,235.94 Median $3,630.78 Typical High $4,168.69 | Facility | None | $3,235.94 | $3,630.78 | $4,168.69 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,344.23 Median $3,630.78 Typical High $3,890.45 | Professional | None | $2,344.23 | $3,630.78 | $3,890.45 |
Providence Setting Facility Modifier None Typical Low $3,630.78 Median $3,630.78 Typical High $3,630.78 | Facility | None | $3,630.78 | $3,630.78 | $3,630.78 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,311.31 Typical High $3,715.35 | Professional | None | $79.43 | $3,311.31 | $3,715.35 |
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 $3,311.31 Median $3,801.89 Typical High $4,466.84 | Professional | None | $3,311.31 | $3,801.89 | $4,466.84 |
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 $1,047.13 Median $3,311.31 Typical High $3,311.31 | Professional | 52 · Reduced service | $1,047.13 | $3,311.31 | $3,311.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $426.58 Median $1,318.26 Typical High $1,318.26 | Professional | 53 · Discontinued | $426.58 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,584.89 Median $4,897.79 Typical High $4,897.79 | Professional | 54 · Surgery only | $1,584.89 | $4,897.79 | $4,897.79 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $316.23 Median $1,000.00 Typical High $1,000.00 | Professional | 55 · Aftercare only | $316.23 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $208.93 Median $660.69 Typical High $660.69 | Professional | 56 · Pre-op care only | $208.93 | $660.69 | $660.69 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,479.11 Median $4,570.88 Typical High $4,570.88 | Professional | 78 · Unplanned return to OR | $1,479.11 | $4,570.88 | $4,570.88 |
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
$3,631
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.