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 $218.78 Median $346.74 Typical High $630.96 | Professional | None | $218.78 | $346.74 | $630.96 |
BCBS Montana Setting Professional Modifier None Typical Low $346.74 Median $346.74 Typical High $346.74 | Professional | None | $346.74 | $346.74 | $346.74 |
Cigna Setting Facility Modifier None Typical Low $346.74 Median $2,630.27 Typical High $7,413.10 | Facility | None | $346.74 | $2,630.27 | $7,413.10 |
Cigna Setting Professional Modifier None Typical Low $288.40 Median $346.74 Typical High $645.65 | Professional | None | $288.40 | $346.74 | $645.65 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $346.74 Median $346.74 Typical High $549.54 | Facility | None | $346.74 | $346.74 | $549.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $223.87 Median $346.74 Typical High $371.54 | Professional | None | $223.87 | $346.74 | $371.54 |
Providence Setting Facility Modifier None Typical Low $346.74 Median $2,630.27 Typical High $7,413.10 | Facility | None | $346.74 | $2,630.27 | $7,413.10 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $316.23 Typical High $354.81 | Professional | None | $79.43 | $316.23 | $354.81 |
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 $331.13 Median $380.19 Typical High $630.96 | Professional | None | $331.13 | $380.19 | $630.96 |
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 $107.15 Median $316.23 Typical High $316.23 | Professional | 52 · Reduced service | $107.15 | $316.23 | $316.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $125.89 Typical High $125.89 | Professional | 53 · Discontinued | $43.65 | $125.89 | $125.89 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $162.18 Median $478.63 Typical High $478.63 | Professional | 54 · Surgery only | $162.18 | $478.63 | $478.63 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $32.36 Median $95.50 Typical High $95.50 | Professional | 55 · Aftercare only | $32.36 | $95.50 | $95.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $63.10 Typical High $63.10 | Professional | 56 · Pre-op care only | $21.88 | $63.10 | $63.10 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $151.36 Median $446.68 Typical High $446.68 | Professional | 78 · Unplanned return to OR | $151.36 | $446.68 | $446.68 |
Where Montana sits
The same service costs 4.6 times more in Alaska than in Utah. 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· 31st of 51
$347
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.