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 $1,202.26 Median $3,715.35 Typical High $3,715.35 | Professional | None | $1,202.26 | $3,715.35 | $3,715.35 |
Cigna Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Cigna Setting Professional Modifier None Typical Low $1,348.96 Median $2,041.74 Typical High $2,187.76 | Professional | None | $1,348.96 | $2,041.74 | $2,187.76 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,862.09 Median $2,089.30 Typical High $2,398.83 | Facility | None | $1,862.09 | $2,089.30 | $2,398.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,348.96 Median $2,089.30 Typical High $2,238.72 | Professional | None | $1,348.96 | $2,089.30 | $2,238.72 |
Providence Setting Facility Modifier None Typical Low $2,041.74 Median $2,041.74 Typical High $2,041.74 | Facility | None | $2,041.74 | $2,041.74 | $2,041.74 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,905.46 Typical High $2,089.30 | Professional | None | $79.43 | $1,905.46 | $2,089.30 |
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 $1,862.09 Median $2,187.76 Typical High $2,570.40 | Professional | None | $1,862.09 | $2,187.76 | $2,570.40 |
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 $602.56 Median $1,862.09 Typical High $1,862.09 | Professional | 52 · Reduced service | $602.56 | $1,862.09 | $1,862.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $239.88 Median $758.58 Typical High $758.58 | Professional | 53 · Discontinued | $239.88 | $758.58 | $758.58 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $891.25 Median $2,818.38 Typical High $2,818.38 | Professional | 54 · Surgery only | $891.25 | $2,818.38 | $2,818.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $181.97 Median $562.34 Typical High $562.34 | Professional | 55 · Aftercare only | $181.97 | $562.34 | $562.34 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $120.23 Median $371.54 Typical High $371.54 | Professional | 56 · Pre-op care only | $120.23 | $371.54 | $371.54 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $831.76 Median $2,630.27 Typical High $2,630.27 | Professional | 78 · Unplanned return to OR | $831.76 | $2,630.27 | $2,630.27 |
Where Montana sits
The same service costs 5.4 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
$2,042
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.