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 $112.20 Median $128.82 Typical High $169.82 | Professional | None | $112.20 | $128.82 | $169.82 |
BCBS Montana Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $223.87 | Facility | None | $190.55 | $190.55 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $154.88 Median $190.55 Typical High $204.17 | Professional | None | $154.88 | $190.55 | $204.17 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $173.78 Median $181.97 Typical High $199.53 | Facility | None | $173.78 | $181.97 | $199.53 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $117.49 Median $181.97 Typical High $194.98 | Professional | None | $117.49 | $181.97 | $194.98 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $223.87 | Facility | None | $190.55 | $190.55 | $223.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $199.53 | Professional | None | $79.43 | $190.55 | $199.53 |
United Setting Professional Modifier None Typical Low $173.78 Median $199.53 Typical High $229.09 | Professional | None | $173.78 | $199.53 | $229.09 |
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 $56.23 Median $85.11 Typical High $85.11 | Professional | 52 · Reduced service | $56.23 | $85.11 | $85.11 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.39 Median $33.88 Typical High $33.88 | Professional | 53 · Discontinued | $22.39 | $33.88 | $33.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.60 Median $25.70 Typical High $25.70 | Professional | 55 · Aftercare only | $16.60 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.22 Median $16.98 Typical High $16.98 | Professional | 56 · Pre-op care only | $11.22 | $16.98 | $16.98 |
Where Montana sits
The same service costs 3.2 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· 11th of 51
$191
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.