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 $89.13 Median $107.15 Typical High $154.88 | Professional | None | $89.13 | $107.15 | $154.88 |
BCBS Montana Setting Professional Modifier None Typical Low $158.49 Median $165.96 Typical High $186.21 | Professional | None | $158.49 | $165.96 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Facility | None | $165.96 | $165.96 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $134.90 Median $165.96 Typical High $186.21 | Professional | None | $134.90 | $165.96 | $186.21 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $154.88 Median $177.83 Typical High $251.19 | Facility | None | $154.88 | $177.83 | $251.19 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $109.65 Median $181.97 Typical High $245.47 | Professional | None | $109.65 | $181.97 | $245.47 |
Providence Setting Facility Modifier None Typical Low $165.96 Median $165.96 Typical High $223.87 | Facility | None | $165.96 | $165.96 | $223.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $165.96 Typical High $190.55 | Professional | None | $79.43 | $165.96 | $190.55 |
United Setting Professional Modifier None Typical Low $158.49 Median $190.55 Typical High $218.78 | Professional | None | $158.49 | $190.55 | $218.78 |
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 $41.69 Median $54.95 Typical High $75.86 | Professional | 52 · Reduced service | $41.69 | $54.95 | $75.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $16.22 Typical High $22.91 | Professional | 55 · Aftercare only | $12.59 | $16.22 | $22.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $10.96 Typical High $15.14 | Professional | 56 · Pre-op care only | $8.51 | $10.96 | $15.14 |
Where Montana sits
The same service costs 2.7 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· 13th of 51
$170
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.