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 $234.42 Median $691.83 Typical High $691.83 | Professional | None | $234.42 | $691.83 | $691.83 |
Cigna Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Cigna Setting Professional Modifier None Typical Low $338.84 Median $398.11 Typical High $426.58 | Professional | None | $338.84 | $398.11 | $426.58 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $467.74 | Facility | None | $398.11 | $398.11 | $467.74 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $257.04 Median $398.11 Typical High $426.58 | Professional | None | $257.04 | $398.11 | $426.58 |
Providence Setting Facility Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Facility | None | $398.11 | $398.11 | $398.11 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $346.74 Typical High $398.11 | Professional | None | $79.43 | $346.74 | $398.11 |
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 $316.23 Median $363.08 Typical High $426.58 | Professional | None | $316.23 | $363.08 | $426.58 |
3 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 54 · Surgery only Typical Low $177.83 Median $512.86 Typical High $512.86 | Professional | 54 · Surgery only | $177.83 | $512.86 | $512.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $35.48 Median $102.33 Typical High $102.33 | Professional | 55 · Aftercare only | $35.48 | $102.33 | $102.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $23.44 Median $69.18 Typical High $69.18 | Professional | 56 · Pre-op care only | $23.44 | $69.18 | $69.18 |
Where Montana sits
The same service costs 8.1 times more in New York than in Missouri. 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· 18th of 51
$380
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.