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 $66.07 Median $91.20 Typical High $128.82 | Professional | None | $66.07 | $91.20 | $128.82 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $190.55 | Facility | None | $131.83 | $131.83 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $112.20 Typical High $112.20 | Professional | None | $104.71 | $112.20 | $112.20 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $123.03 Median $144.54 Typical High $194.98 | Facility | None | $123.03 | $144.54 | $194.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $81.28 Median $125.89 Typical High $190.55 | Professional | None | $81.28 | $125.89 | $190.55 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $190.55 | Facility | None | $131.83 | $131.83 | $190.55 |
Providence Setting Professional Modifier None Typical Low $81.28 Median $104.71 Typical High $138.04 | Professional | None | $81.28 | $104.71 | $138.04 |
United Setting Professional Modifier None Typical Low $138.04 Median $162.18 Typical High $186.21 | Professional | None | $138.04 | $162.18 | $186.21 |
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 $33.11 Median $45.71 Typical High $64.57 | Professional | 52 · Reduced service | $33.11 | $45.71 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $13.80 Typical High $19.05 | Professional | 55 · Aftercare only | $9.77 | $13.80 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.61 Median $9.12 Typical High $12.88 | Professional | 56 · Pre-op care only | $6.61 | $9.12 | $12.88 |
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· 12th of 51
$112
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.