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 $41.69 Median $57.54 Typical High $85.11 | Professional | None | $41.69 | $57.54 | $85.11 |
BCBS Montana Setting Professional Modifier None Typical Low $75.86 Median $75.86 Typical High $95.50 | Professional | None | $75.86 | $75.86 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $128.82 | Facility | None | $83.18 | $83.18 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $69.18 Median $70.79 Typical High $70.79 | Professional | None | $69.18 | $70.79 | $70.79 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $77.62 Median $93.33 Typical High $131.83 | Facility | None | $77.62 | $93.33 | $131.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $52.48 Median $81.28 Typical High $128.82 | Professional | None | $52.48 | $81.28 | $128.82 |
Providence Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $128.82 | Facility | None | $83.18 | $83.18 | $128.82 |
Providence Setting Professional Modifier None Typical Low $56.23 Median $70.79 Typical High $91.20 | Professional | None | $56.23 | $70.79 | $91.20 |
United Setting Professional Modifier None Typical Low $87.10 Median $102.33 Typical High $125.89 | Professional | None | $87.10 | $102.33 | $125.89 |
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 $20.89 Median $28.84 Typical High $42.66 | Professional | 52 · Reduced service | $20.89 | $28.84 | $42.66 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.31 Median $8.71 Typical High $12.88 | Professional | 55 · Aftercare only | $6.31 | $8.71 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.17 Median $5.75 Typical High $8.51 | Professional | 56 · Pre-op care only | $4.17 | $5.75 | $8.51 |
Where Montana sits
The same service costs 2.6 times more in Alaska than in Kentucky. 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
$70.79
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.