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 $70.79 Median $97.72 Typical High $102.33 | Professional | None | $70.79 | $97.72 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $134.90 | Facility | None | $114.82 | $114.82 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $97.72 Median $114.82 Typical High $138.04 | Professional | None | $97.72 | $114.82 | $138.04 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $112.20 Median $131.83 Typical High $144.54 | Facility | None | $112.20 | $131.83 | $144.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $83.18 Median $128.82 Typical High $138.04 | Professional | None | $83.18 | $128.82 | $138.04 |
Providence Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $134.90 | Facility | None | $114.82 | $114.82 | $134.90 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $109.65 Typical High $120.23 | Professional | None | $79.43 | $109.65 | $120.23 |
United Setting Professional Modifier None Typical Low $109.65 Median $125.89 Typical High $141.25 | Professional | None | $109.65 | $125.89 | $141.25 |
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 $35.48 Median $48.98 Typical High $51.29 | Professional | 52 · Reduced service | $35.48 | $48.98 | $51.29 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $19.50 Typical High $20.42 | Professional | 53 · Discontinued | $14.13 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.72 Median $14.45 Typical High $15.49 | Professional | 55 · Aftercare only | $10.72 | $14.45 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $9.77 Typical High $10.23 | Professional | 56 · Pre-op care only | $7.08 | $9.77 | $10.23 |
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· 15th of 51
$115
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.