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 $104.71 Median $147.91 Typical High $208.93 | Professional | None | $104.71 | $147.91 | $208.93 |
BCBS Montana Setting Professional Modifier None Typical Low $208.93 Median $223.87 Typical High $263.03 | Professional | None | $208.93 | $223.87 | $263.03 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $316.23 | Facility | None | $208.93 | $208.93 | $316.23 |
Cigna Setting Professional Modifier None Typical Low $169.82 Median $208.93 Typical High $263.03 | Professional | None | $169.82 | $208.93 | $263.03 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $177.83 Median $229.09 Typical High $331.13 | Facility | None | $177.83 | $229.09 | $331.13 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $162.18 Median $213.80 Typical High $323.59 | Professional | None | $162.18 | $213.80 | $323.59 |
Providence Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $316.23 | Facility | None | $208.93 | $208.93 | $316.23 |
Providence Setting Professional Modifier None Typical Low $128.82 Median $190.55 Typical High $263.03 | Professional | None | $128.82 | $190.55 | $263.03 |
United Setting Professional Modifier None Typical Low $177.83 Median $229.09 Typical High $281.84 | Professional | None | $177.83 | $229.09 | $281.84 |
3 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 $53.70 Median $69.18 Typical High $104.71 | Professional | 52 · Reduced service | $53.70 | $69.18 | $104.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.22 Median $20.89 Typical High $30.90 | Professional | 55 · Aftercare only | $16.22 | $20.89 | $30.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.72 Median $13.80 Typical High $20.89 | Professional | 56 · Pre-op care only | $10.72 | $13.80 | $20.89 |
Where Montana sits
The same service costs 2.3 times more in Alaska than in Alabama. 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· 8th of 51
$209
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.