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 $354.81 Median $416.87 Typical High $1,174.90 | Professional | None | $354.81 | $416.87 | $1,174.90 |
BCBS Montana Setting Professional Modifier None Typical Low $645.65 Median $645.65 Typical High $645.65 | Professional | None | $645.65 | $645.65 | $645.65 |
Cigna Setting Facility Modifier None Typical Low $645.65 Median $2,818.38 Typical High $7,943.28 | Facility | None | $645.65 | $2,818.38 | $7,943.28 |
Cigna Setting Professional Modifier None Typical Low $426.58 Median $645.65 Typical High $660.69 | Professional | None | $426.58 | $645.65 | $660.69 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $575.44 Median $676.08 Typical High $776.25 | Facility | None | $575.44 | $676.08 | $776.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $436.52 Median $676.08 Typical High $724.44 | Professional | None | $436.52 | $676.08 | $724.44 |
Providence Setting Facility Modifier None Typical Low $645.65 Median $2,818.38 Typical High $7,943.28 | Facility | None | $645.65 | $2,818.38 | $7,943.28 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $588.84 Typical High $660.69 | Professional | None | $79.43 | $588.84 | $660.69 |
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 $575.44 Median $660.69 Typical High $794.33 | Professional | None | $575.44 | $660.69 | $794.33 |
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 $190.55 Median $588.84 Typical High $588.84 | Professional | 52 · Reduced service | $190.55 | $588.84 | $588.84 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $75.86 Median $234.42 Typical High $234.42 | Professional | 53 · Discontinued | $75.86 | $234.42 | $234.42 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $288.40 Median $870.96 Typical High $870.96 | Professional | 54 · Surgery only | $288.40 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $57.54 Median $177.83 Typical High $177.83 | Professional | 55 · Aftercare only | $57.54 | $177.83 | $177.83 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $38.02 Median $117.49 Typical High $117.49 | Professional | 56 · Pre-op care only | $38.02 | $117.49 | $117.49 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $269.15 Median $812.83 Typical High $812.83 | Professional | 78 · Unplanned return to OR | $269.15 | $812.83 | $812.83 |
Where Montana sits
The same service costs 5.6 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· 15th of 51
$646
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.