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 Facility Modifier None Typical Low $63.10 Median $93.33 Typical High $346.74 | Facility | None | $63.10 | $93.33 | $346.74 |
Aetna Setting Professional Modifier None Typical Low $24.55 Median $41.69 Typical High $64.57 | Professional | None | $24.55 | $41.69 | $64.57 |
BCBS Montana Setting Professional Modifier None Typical Low $54.95 Median $75.86 Typical High $89.13 | Professional | None | $54.95 | $75.86 | $89.13 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $107.15 | Facility | None | $54.95 | $54.95 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $46.77 Median $54.95 Typical High $89.13 | Professional | None | $46.77 | $54.95 | $89.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $39.81 Median $60.26 Typical High $109.65 | Facility | None | $39.81 | $60.26 | $109.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $50.12 Median $57.54 Typical High $109.65 | Professional | None | $50.12 | $57.54 | $109.65 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $107.15 | Facility | None | $54.95 | $54.95 | $107.15 |
Providence Setting Professional Modifier None Typical Low $37.15 Median $57.54 Typical High $89.13 | Professional | None | $37.15 | $57.54 | $89.13 |
United Setting Professional Modifier None Typical Low $37.15 Median $56.23 Typical High $77.62 | Professional | None | $37.15 | $56.23 | $77.62 |
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 $13.49 Median $21.88 Typical High $34.67 | Professional | 52 · Reduced service | $13.49 | $21.88 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.98 Median $6.61 Typical High $10.47 | Professional | 55 · Aftercare only | $3.98 | $6.61 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.69 Median $4.37 Typical High $6.92 | Professional | 56 · Pre-op care only | $2.69 | $4.37 | $6.92 |
Where Montana sits
The same service costs 2.4 times more in Alaska than in New Jersey. 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· 7th of 51
$57.54
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.