How much rates vary
Facilitymedian $661 · 10th to 90th $105 to $1,148Professionalmedian $182 · 10th to 90th $79 to $1,000
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 $66.07 Median $389.05 Typical High $1,778.28 | Professional | None | $66.07 | $389.05 | $1,778.28 |
BCBS Montana Setting Professional Modifier None Typical Low $107.15 Median $107.15 Typical High $912.01 | Professional | None | $107.15 | $107.15 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $107.15 Median $1,445.44 Typical High $4,073.80 | Facility | None | $107.15 | $1,445.44 | $4,073.80 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $288.40 Typical High $912.01 | Professional | None | $104.71 | $288.40 | $912.01 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $1,023.29 | Facility | None | $104.71 | $131.83 | $1,023.29 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $67.61 Median $128.82 Typical High $1,000.00 | Professional | None | $67.61 | $128.82 | $1,000.00 |
Providence Setting Facility Modifier None Typical Low $107.15 Median $1,445.44 Typical High $4,073.80 | Facility | None | $107.15 | $1,445.44 | $4,073.80 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $1,000.00 | Professional | None | $79.43 | $109.65 | $1,000.00 |
United Setting Facility Modifier None Typical Low $602.56 Median $1,000.00 Typical High $1,862.09 | Facility | None | $602.56 | $1,000.00 | $1,862.09 |
United Setting Professional Modifier None Typical Low $109.65 Median $501.19 Typical High $1,071.52 | Professional | None | $109.65 | $501.19 | $1,071.52 |
5 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 $34.67 Median $194.98 Typical High $891.25 | Professional | 52 · Reduced service | $34.67 | $194.98 | $891.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $77.62 Typical High $354.81 | Professional | 53 · Discontinued | $13.80 | $77.62 | $354.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $52.48 Median $295.12 Typical High $1,348.96 | Professional | 54 · Surgery only | $52.48 | $295.12 | $1,348.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $58.88 Typical High $269.15 | Professional | 55 · Aftercare only | $10.47 | $58.88 | $269.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $38.90 Typical High $177.83 | Professional | 56 · Pre-op care only | $6.92 | $38.90 | $177.83 |
Where Montana sits
The same service costs 5.6 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 $4,728MT $843
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.