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 $10.47 Median $12.59 Typical High $19.05 | Professional | None | $10.47 | $12.59 | $19.05 |
BCBS Montana Setting Professional Modifier None Typical Low $17.78 Median $17.78 Typical High $17.78 | Professional | None | $17.78 | $17.78 | $17.78 |
Cigna Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $21.38 | Facility | None | $17.78 | $17.78 | $21.38 |
Cigna Setting Professional Modifier None Typical Low $11.75 Median $15.14 Typical High $15.14 | Professional | None | $11.75 | $15.14 | $15.14 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $19.95 Median $20.42 Typical High $22.91 | Facility | None | $19.95 | $20.42 | $22.91 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $12.88 Median $19.95 Typical High $21.38 | Professional | None | $12.88 | $19.95 | $21.38 |
Providence Setting Facility Modifier None Typical Low $17.78 Median $17.78 Typical High $21.38 | Facility | None | $17.78 | $17.78 | $21.38 |
Providence Setting Professional Modifier None Typical Low $11.48 Median $15.14 Typical High $79.43 | Professional | None | $11.48 | $15.14 | $79.43 |
United Setting Professional Modifier None Typical Low $16.98 Median $19.50 Typical High $22.39 | Professional | None | $16.98 | $19.50 | $22.39 |
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 $5.25 Median $6.31 Typical High $7.76 | Professional | 52 · Reduced service | $5.25 | $6.31 | $7.76 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $2.09 Median $2.51 Typical High $3.09 | Professional | 53 · Discontinued | $2.09 | $2.51 | $3.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1.55 Median $1.86 Typical High $2.29 | Professional | 55 · Aftercare only | $1.55 | $1.86 | $2.29 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.05 Median $1.26 Typical High $1.55 | Professional | 56 · Pre-op care only | $1.05 | $1.26 | $1.55 |
Where Montana sits
The same service costs 2.6 times more in Alaska than in Kentucky. 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· 14th of 51
$15.14
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.