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 $50.12 Median $100.00 Typical High $194.98 | Professional | None | $50.12 | $100.00 | $194.98 |
BCBS Montana Setting Professional Modifier None Typical Low $67.61 Median $67.61 Typical High $141.25 | Professional | None | $67.61 | $67.61 | $141.25 |
Cigna Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $114.82 Typical High $141.25 | Professional | None | $67.61 | $114.82 | $141.25 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $64.57 Median $114.82 Typical High $169.82 | Facility | None | $64.57 | $114.82 | $169.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $41.69 Median $79.43 Typical High $165.96 | Professional | None | $41.69 | $79.43 | $165.96 |
Providence Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $79.43 Typical High $141.25 | Professional | None | $57.54 | $79.43 | $141.25 |
United Setting Professional Modifier None Typical Low $69.18 Median $125.89 Typical High $165.96 | Professional | None | $69.18 | $125.89 | $165.96 |
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 $21.88 Median $50.12 Typical High $97.72 | Professional | 52 · Reduced service | $21.88 | $50.12 | $97.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $19.95 Typical High $39.81 | Professional | 53 · Discontinued | $8.71 | $19.95 | $39.81 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $32.36 Median $74.13 Typical High $147.91 | Professional | 54 · Surgery only | $32.36 | $74.13 | $147.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.46 Median $14.79 Typical High $29.51 | Professional | 55 · Aftercare only | $6.46 | $14.79 | $29.51 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $10.00 Typical High $19.50 | Professional | 56 · Pre-op care only | $4.37 | $10.00 | $19.50 |
Where Montana sits
The same service costs 2.5 times more in North Carolina than in Florida. 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· 35th of 51
$89.13
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.