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 $0.30 Median $0.39 Typical High $0.44 | Professional | None | $0.30 | $0.39 | $0.44 |
Cigna Setting Professional Modifier None Typical Low $0.48 Median $0.52 Typical High $0.52 | Professional | None | $0.48 | $0.52 | $0.52 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $0.56 Median $0.58 Typical High $0.66 | Facility | None | $0.56 | $0.58 | $0.66 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $0.37 Median $0.56 Typical High $0.62 | Professional | None | $0.37 | $0.56 | $0.62 |
Providence Setting Facility Modifier None Typical Low $0.52 Median $0.52 Typical High $0.63 | Facility | None | $0.52 | $0.52 | $0.63 |
Providence Setting Professional Modifier None Typical Low $0.48 Median $0.52 Typical High $79.43 | Professional | None | $0.48 | $0.52 | $79.43 |
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 $0.15 Median $0.20 Typical High $0.22 | Professional | 52 · Reduced service | $0.15 | $0.20 | $0.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.06 Median $0.08 Typical High $0.09 | Professional | 53 · Discontinued | $0.06 | $0.08 | $0.09 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.05 Median $0.06 Typical High $0.07 | Professional | 55 · Aftercare only | $0.05 | $0.06 | $0.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.03 Median $0.04 Typical High $0.04 | Professional | 56 · Pre-op care only | $0.03 | $0.04 | $0.04 |
Where Montana sits
The same service costs 645.7 times more in Oklahoma 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· 20th of 51
$0.52
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.