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 $112.20 Median $162.18 Typical High $251.19 | Professional | None | $112.20 | $162.18 | $251.19 |
Cigna Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $302.00 | Facility | None | $208.93 | $208.93 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $177.83 Median $208.93 Typical High $251.19 | Professional | None | $177.83 | $208.93 | $251.19 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $229.09 Median $269.15 Typical High $302.00 | Facility | None | $229.09 | $269.15 | $302.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $169.82 Median $245.47 Typical High $295.12 | Professional | None | $169.82 | $245.47 | $295.12 |
Providence Setting Facility Modifier None Typical Low $208.93 Median $208.93 Typical High $302.00 | Facility | None | $208.93 | $208.93 | $302.00 |
Providence Setting Professional Modifier None Typical Low $141.25 Median $208.93 Typical High $275.42 | Professional | None | $141.25 | $208.93 | $275.42 |
United Setting Professional Modifier None Typical Low $208.93 Median $263.03 Typical High $323.59 | Professional | None | $208.93 | $263.03 | $323.59 |
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 $51.29 Median $75.86 Typical High $125.89 | Professional | 52 · Reduced service | $51.29 | $75.86 | $125.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $23.99 Typical High $37.15 | Professional | 55 · Aftercare only | $17.38 | $23.99 | $37.15 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.75 Median $16.22 Typical High $25.12 | Professional | 56 · Pre-op care only | $11.75 | $16.22 | $25.12 |
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· 7th of 51
$214
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.