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 $79.43 Median $123.03 Typical High $123.03 | Professional | None | $79.43 | $123.03 | $123.03 |
Cigna Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $162.18 | Facility | None | $138.04 | $138.04 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $112.20 Median $138.04 Typical High $147.91 | Professional | None | $112.20 | $138.04 | $147.91 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $125.89 Median $131.83 Typical High $144.54 | Facility | None | $125.89 | $131.83 | $144.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $85.11 Median $128.82 Typical High $138.04 | Professional | None | $85.11 | $128.82 | $138.04 |
Providence Setting Facility Modifier None Typical Low $138.04 Median $138.04 Typical High $162.18 | Facility | None | $138.04 | $138.04 | $162.18 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $138.04 Typical High $144.54 | Professional | None | $79.43 | $138.04 | $144.54 |
United Setting Professional Modifier None Typical Low $125.89 Median $147.91 Typical High $169.82 | Professional | None | $125.89 | $147.91 | $169.82 |
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 $39.81 Median $61.66 Typical High $61.66 | Professional | 52 · Reduced service | $39.81 | $61.66 | $61.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $24.55 Typical High $24.55 | Professional | 53 · Discontinued | $16.22 | $24.55 | $24.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $18.62 Typical High $18.62 | Professional | 55 · Aftercare only | $12.02 | $18.62 | $18.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $12.30 Typical High $12.30 | Professional | 56 · Pre-op care only | $7.94 | $12.30 | $12.30 |
Where Montana sits
The same service costs 3.1 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
$138
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.