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 $100.00 Median $131.83 Typical High $144.54 | Professional | None | $100.00 | $131.83 | $144.54 |
BCBS Montana Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $190.55 | Facility | None | $162.18 | $162.18 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $162.18 Typical High $177.83 | Professional | None | $134.90 | $162.18 | $177.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $151.36 Median $181.97 Typical High $199.53 | Facility | None | $151.36 | $181.97 | $199.53 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $117.49 Median $177.83 Typical High $190.55 | Professional | None | $117.49 | $177.83 | $190.55 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $190.55 | Facility | None | $162.18 | $162.18 | $190.55 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $154.88 Typical High $173.78 | Professional | None | $79.43 | $154.88 | $173.78 |
United Setting Professional Modifier None Typical Low $144.54 Median $169.82 Typical High $186.21 | Professional | None | $144.54 | $169.82 | $186.21 |
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 $50.12 Median $66.07 Typical High $72.44 | Professional | 52 · Reduced service | $50.12 | $66.07 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $26.30 Typical High $28.84 | Professional | 53 · Discontinued | $19.95 | $26.30 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $19.95 Typical High $21.88 | Professional | 55 · Aftercare only | $15.14 | $19.95 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $13.18 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.00 | $13.18 | $14.45 |
Where Montana sits
The same service costs 3.0 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· 14th of 51
$162
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.