How much rates vary
Facilitymedian $1,047 · 10th to 90th $912 to $4,898Professionalmedian $1,023 · 10th to 90th $437 to $1,175
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 $588.84 Median $724.44 Typical High $1,819.70 | Professional | None | $588.84 | $724.44 | $1,819.70 |
BCBS Montana Setting Professional Modifier None Typical Low $1,023.29 Median $1,023.29 Typical High $1,023.29 | Professional | None | $1,023.29 | $1,023.29 | $1,023.29 |
Cigna Setting Facility Modifier None Typical Low $1,023.29 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,023.29 | $4,897.79 | $13,803.84 |
Cigna Setting Professional Modifier None Typical Low $676.08 Median $1,023.29 Typical High $1,071.52 | Professional | None | $676.08 | $1,023.29 | $1,071.52 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $912.01 Median $1,023.29 Typical High $1,174.90 | Facility | None | $912.01 | $1,023.29 | $1,174.90 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $660.69 Median $1,023.29 Typical High $1,096.48 | Professional | None | $660.69 | $1,023.29 | $1,096.48 |
Providence Setting Facility Modifier None Typical Low $1,023.29 Median $4,897.79 Typical High $13,803.84 | Facility | None | $1,023.29 | $4,897.79 | $13,803.84 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $912.01 Typical High $1,023.29 | Professional | None | $79.43 | $912.01 | $1,023.29 |
United Setting Facility Modifier None Typical Low $2,089.30 Median $3,981.07 Typical High $7,079.46 | Facility | None | $2,089.30 | $3,981.07 | $7,079.46 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,071.52 Typical High $1,258.93 | Professional | None | $912.01 | $1,071.52 | $1,258.93 |
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 $295.12 Median $912.01 Typical High $912.01 | Professional | 52 · Reduced service | $295.12 | $912.01 | $912.01 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $117.49 Median $363.08 Typical High $363.08 | Professional | 53 · Discontinued | $117.49 | $363.08 | $363.08 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $446.68 Median $1,380.38 Typical High $1,380.38 | Professional | 54 · Surgery only | $446.68 | $1,380.38 | $1,380.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $89.13 Median $275.42 Typical High $275.42 | Professional | 55 · Aftercare only | $89.13 | $275.42 | $275.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $58.88 Median $181.97 Typical High $181.97 | Professional | 56 · Pre-op care only | $58.88 | $181.97 | $181.97 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $416.87 Median $1,288.25 Typical High $1,288.25 | Professional | 78 · Unplanned return to OR | $416.87 | $1,288.25 | $1,288.25 |
Where Montana sits
The same service costs 5.4 times more in Colorado 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
CO $11,084MT $2,070
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.