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 $29.51 Median $72.44 Typical High $117.49 | Professional | None | $29.51 | $72.44 | $117.49 |
BCBS Montana Setting Professional Modifier None Typical Low $39.81 Median $44.67 Typical High $131.83 | Professional | None | $39.81 | $44.67 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $154.88 | Facility | None | $44.67 | $44.67 | $154.88 |
Cigna Setting Professional Modifier None Typical Low $39.81 Median $77.62 Typical High $131.83 | Professional | None | $39.81 | $77.62 | $131.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $40.74 Median $51.29 Typical High $158.49 | Facility | None | $40.74 | $51.29 | $158.49 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $26.30 Median $45.71 Typical High $154.88 | Professional | None | $26.30 | $45.71 | $154.88 |
Providence Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $154.88 | Facility | None | $44.67 | $44.67 | $154.88 |
Providence Setting Professional Modifier None Typical Low $38.90 Median $79.43 Typical High $134.90 | Professional | None | $38.90 | $79.43 | $134.90 |
United Setting Professional Modifier None Typical Low $45.71 Median $83.18 Typical High $147.91 | Professional | None | $45.71 | $83.18 | $147.91 |
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 $14.79 Median $36.31 Typical High $58.88 | Professional | 52 · Reduced service | $14.79 | $36.31 | $58.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $14.45 Typical High $23.44 | Professional | 53 · Discontinued | $6.03 | $14.45 | $23.44 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $10.72 Typical High $17.78 | Professional | 55 · Aftercare only | $4.47 | $10.72 | $17.78 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $7.24 Typical High $11.75 | Professional | 56 · Pre-op care only | $3.02 | $7.24 | $11.75 |
Where Montana sits
The same service costs 3.6 times more in North Carolina than in Washington, DC. 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· 28th of 51
$79.43
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.