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 $15.85 Median $24.55 Typical High $24.55 | Professional | None | $15.85 | $24.55 | $24.55 |
Cigna Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $32.36 | Facility | None | $27.54 | $27.54 | $32.36 |
Cigna Setting Professional Modifier None Typical Low $22.91 Median $27.54 Typical High $30.20 | Professional | None | $22.91 | $27.54 | $30.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $25.70 Median $31.62 Typical High $34.67 | Facility | None | $25.70 | $31.62 | $34.67 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $20.42 Median $31.62 Typical High $33.88 | Professional | None | $20.42 | $31.62 | $33.88 |
Providence Setting Facility Modifier None Typical Low $27.54 Median $27.54 Typical High $32.36 | Facility | None | $27.54 | $27.54 | $32.36 |
Providence Setting Professional Modifier None Typical Low $18.20 Median $28.18 Typical High $79.43 | Professional | None | $18.20 | $28.18 | $79.43 |
United Setting Professional Modifier None Typical Low $25.70 Median $29.51 Typical High $34.67 | Professional | None | $25.70 | $29.51 | $34.67 |
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 $7.94 Median $12.30 Typical High $12.30 | Professional | 52 · Reduced service | $7.94 | $12.30 | $12.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.16 Median $4.90 Typical High $4.90 | Professional | 53 · Discontinued | $3.16 | $4.90 | $4.90 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.40 Median $3.72 Typical High $3.72 | Professional | 55 · Aftercare only | $2.40 | $3.72 | $3.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.58 Median $2.45 Typical High $2.45 | Professional | 56 · Pre-op care only | $1.58 | $2.45 | $2.45 |
Where Montana sits
The same service costs 3.4 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· 12th of 51
$28.18
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.