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 $602.56 Median $870.96 Typical High $1,288.25 | Professional | None | $602.56 | $870.96 | $1,288.25 |
Cigna Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Facility | None | $1,202.26 | $1,202.26 | $1,412.54 |
Cigna Setting Professional Modifier None Typical Low $831.76 Median $1,202.26 Typical High $1,202.26 | Professional | None | $831.76 | $1,202.26 | $1,202.26 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $891.25 Median $1,380.38 Typical High $1,513.56 | Facility | None | $891.25 | $1,380.38 | $1,513.56 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $870.96 Median $1,348.96 Typical High $1,445.44 | Professional | None | $870.96 | $1,348.96 | $1,445.44 |
Providence Setting Facility Modifier None Typical Low $1,202.26 Median $1,202.26 Typical High $1,412.54 | Facility | None | $1,202.26 | $1,202.26 | $1,412.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,202.26 Typical High $1,230.27 | Professional | None | $79.43 | $1,202.26 | $1,230.27 |
United Setting Professional Modifier None Typical Low $912.01 Median $1,047.13 Typical High $1,230.27 | Professional | None | $912.01 | $1,047.13 | $1,230.27 |
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 $302.00 Median $537.03 Typical High $537.03 | Professional | 52 · Reduced service | $302.00 | $537.03 | $537.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $120.23 Median $213.80 Typical High $213.80 | Professional | 53 · Discontinued | $120.23 | $213.80 | $213.80 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $91.20 Median $162.18 Typical High $162.18 | Professional | 55 · Aftercare only | $91.20 | $162.18 | $162.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $60.26 Median $107.15 Typical High $107.15 | Professional | 56 · Pre-op care only | $60.26 | $107.15 | $107.15 |
Where Montana sits
The same service costs 3.2 times more in Alaska than in New York. 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· 10th of 51
$1,148
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.