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 $218.78 Median $295.12 Typical High $416.87 | Professional | None | $218.78 | $295.12 | $416.87 |
BCBS Montana Setting Professional Modifier None Typical Low $457.09 Median $457.09 Typical High $457.09 | Professional | None | $457.09 | $457.09 | $457.09 |
Cigna Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $549.54 | Facility | None | $457.09 | $457.09 | $549.54 |
Cigna Setting Professional Modifier None Typical Low $302.00 Median $457.09 Typical High $457.09 | Professional | None | $302.00 | $457.09 | $457.09 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $331.13 Median $537.03 Typical High $588.84 | Facility | None | $331.13 | $537.03 | $588.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $346.74 Median $524.81 Typical High $562.34 | Professional | None | $346.74 | $524.81 | $562.34 |
Providence Setting Facility Modifier None Typical Low $457.09 Median $457.09 Typical High $549.54 | Facility | None | $457.09 | $457.09 | $549.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $457.09 Typical High $467.74 | Professional | None | $79.43 | $457.09 | $467.74 |
United Setting Professional Modifier None Typical Low $338.84 Median $389.05 Typical High $446.68 | Professional | None | $338.84 | $389.05 | $446.68 |
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 $109.65 Median $204.17 Typical High $204.17 | Professional | 52 · Reduced service | $109.65 | $204.17 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $43.65 Median $81.28 Typical High $81.28 | Professional | 53 · Discontinued | $43.65 | $81.28 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $33.11 Median $61.66 Typical High $61.66 | Professional | 55 · Aftercare only | $33.11 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $21.88 Median $40.74 Typical High $40.74 | Professional | 56 · Pre-op care only | $21.88 | $40.74 | $40.74 |
Where Montana sits
The same service costs 2.8 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· 8th of 51
$457
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.