How much rates vary
Facilitymedian $1,000 · 10th to 90th $851 to $2,818Professionalmedian $955 · 10th to 90th $79 to $1,122
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 $562.34 Median $1,737.80 Typical High $1,737.80 | Professional | None | $562.34 | $1,737.80 | $1,737.80 |
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 $630.96 Median $954.99 Typical High $1,000.00 | Professional | None | $630.96 | $954.99 | $1,000.00 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $851.14 Median $1,000.00 Typical High $1,148.15 | Facility | None | $851.14 | $1,000.00 | $1,148.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $645.65 Median $1,000.00 Typical High $1,071.52 | Professional | None | $645.65 | $1,000.00 | $1,071.52 |
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 $870.96 Typical High $977.24 | Professional | None | $79.43 | $870.96 | $977.24 |
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 $851.14 Median $1,000.00 Typical High $1,174.90 | Professional | None | $851.14 | $1,000.00 | $1,174.90 |
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 $281.84 Median $870.96 Typical High $870.96 | Professional | 52 · Reduced service | $281.84 | $870.96 | $870.96 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $112.20 Median $346.74 Typical High $346.74 | Professional | 53 · Discontinued | $112.20 | $346.74 | $346.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $416.87 Median $1,318.26 Typical High $1,318.26 | Professional | 54 · Surgery only | $416.87 | $1,318.26 | $1,318.26 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $85.11 Median $263.03 Typical High $263.03 | Professional | 55 · Aftercare only | $85.11 | $263.03 | $263.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $56.23 Median $173.78 Typical High $173.78 | Professional | 56 · Pre-op care only | $56.23 | $173.78 | $173.78 |
Aetna Setting Professional Modifier 78 · Unplanned return to OR Typical Low $389.05 Median $1,230.27 Typical High $1,230.27 | Professional | 78 · Unplanned return to OR | $389.05 | $1,230.27 | $1,230.27 |
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 $7,787MT $1,955
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.