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 $2,454.71 Median $7,413.10 Typical High $7,413.10 | Professional | None | $2,454.71 | $7,413.10 | $7,413.10 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $3,630.78 Median $4,365.16 Typical High $5,011.87 | Facility | None | $3,630.78 | $4,365.16 | $5,011.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2,818.38 Median $4,365.16 Typical High $4,677.35 | Professional | None | $2,818.38 | $4,365.16 | $4,677.35 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $3,548.13 Typical High $4,168.69 | Professional | None | $79.43 | $3,548.13 | $4,168.69 |
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 $3,630.78 Median $4,265.80 Typical High $5,011.87 | Professional | None | $3,630.78 | $4,265.80 | $5,011.87 |
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 $1,230.27 Median $3,715.35 Typical High $3,715.35 | Professional | 52 · Reduced service | $1,230.27 | $3,715.35 | $3,715.35 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $489.78 Median $1,479.11 Typical High $1,479.11 | Professional | 53 · Discontinued | $489.78 | $1,479.11 | $1,479.11 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $1,819.70 Median $5,623.41 Typical High $5,623.41 | Professional | 54 · Surgery only | $1,819.70 | $5,623.41 | $5,623.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $363.08 Median $1,122.02 Typical High $1,122.02 | Professional | 55 · Aftercare only | $363.08 | $1,122.02 | $1,122.02 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $245.47 Median $741.31 Typical High $741.31 | Professional | 56 · Pre-op care only | $245.47 | $741.31 | $741.31 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $1,698.24 Median $5,248.07 Typical High $5,248.07 | Professional | 78 · Unplanned return to OR | $1,698.24 | $5,248.07 | $5,248.07 |
Where Montana sits
The same service costs 26.9 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· 16th of 51
$3,981
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.