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 $64.57 Median $72.44 Typical High $100.00 | Professional | None | $64.57 | $72.44 | $100.00 |
BCBS Montana Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $131.83 | Facility | None | $109.65 | $109.65 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $91.20 Median $109.65 Typical High $120.23 | Professional | None | $91.20 | $109.65 | $120.23 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $102.33 Median $107.15 Typical High $114.82 | Facility | None | $102.33 | $107.15 | $114.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $67.61 Median $104.71 Typical High $112.20 | Professional | None | $67.61 | $104.71 | $112.20 |
Providence Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $131.83 | Facility | None | $109.65 | $109.65 | $131.83 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $109.65 Typical High $117.49 | Professional | None | $74.13 | $109.65 | $117.49 |
United Setting Professional Modifier None Typical Low $102.33 Median $117.49 Typical High $131.83 | Professional | None | $102.33 | $117.49 | $131.83 |
4 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 $32.36 Median $50.12 Typical High $50.12 | Professional | 52 · Reduced service | $32.36 | $50.12 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.88 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $12.88 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.55 Median $15.14 Typical High $15.14 | Professional | 55 · Aftercare only | $9.55 | $15.14 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.46 | $10.00 | $10.00 |
Where Montana sits
The same service costs 3.2 times more in Alaska 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· 11th of 51
$110
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.