How much rates vary
Facilitymedian $977 · 10th to 90th $832 to $2,818Professionalmedian $955 · 10th to 90th $85 to $1,072
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 $549.54 Median $758.58 Typical High $1,698.24 | Professional | None | $549.54 | $758.58 | $1,698.24 |
BCBS Montana Setting Professional Modifier None Typical Low $954.99 Median $954.99 Typical High $954.99 | Professional | None | $954.99 | $954.99 | $954.99 |
Cigna Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $7,943.28 | Facility | None | $954.99 | $2,818.38 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $616.60 Median $954.99 Typical High $977.24 | Professional | None | $616.60 | $954.99 | $977.24 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $831.76 Median $977.24 Typical High $1,122.02 | Facility | None | $831.76 | $977.24 | $1,122.02 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $630.96 Median $977.24 Typical High $1,047.13 | Professional | None | $630.96 | $977.24 | $1,047.13 |
Providence Setting Facility Modifier None Typical Low $954.99 Median $2,818.38 Typical High $7,943.28 | Facility | None | $954.99 | $2,818.38 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $851.14 Typical High $954.99 | Professional | None | $79.43 | $851.14 | $954.99 |
United Setting Facility Modifier None Typical Low $1,479.11 Median $2,884.03 Typical High $4,570.88 | Facility | None | $1,479.11 | $2,884.03 | $4,570.88 |
United Setting Professional Modifier None Typical Low $831.76 Median $977.24 Typical High $1,148.15 | Professional | None | $831.76 | $977.24 | $1,148.15 |
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 $275.42 Median $851.14 Typical High $851.14 | Professional | 52 · Reduced service | $275.42 | $851.14 | $851.14 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $109.65 Median $338.84 Typical High $338.84 | Professional | 53 · Discontinued | $109.65 | $338.84 | $338.84 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $1,288.25 Typical High $1,288.25 | Professional | 54 · Surgery only | $416.87 | $1,288.25 | $1,288.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $83.18 Median $257.04 Typical High $257.04 | Professional | 55 · Aftercare only | $83.18 | $257.04 | $257.04 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $54.95 Median $169.82 Typical High $169.82 | Professional | 56 · Pre-op care only | $54.95 | $169.82 | $169.82 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $1,202.26 Typical High $1,202.26 | Professional | 78 · Unplanned return to OR | $389.05 | $1,202.26 | $1,202.26 |
Where Montana sits
The same service costs 4.0 times more in Oklahoma than in Montana. 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.
Physician feeFacility fee
OK $7,771MT $1,932
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.