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 $64.57 Median $100.00 Typical High $162.18 | Professional | None | $64.57 | $100.00 | $162.18 |
BCBS Montana Setting Professional Modifier None Typical Low $128.82 Median $158.49 Typical High $186.21 | Professional | None | $128.82 | $158.49 | $186.21 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $223.87 | Facility | None | $128.82 | $128.82 | $223.87 |
Cigna Setting Professional Modifier None Typical Low $109.65 Median $128.82 Typical High $186.21 | Professional | None | $109.65 | $128.82 | $186.21 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $120.23 Median $144.54 Typical High $229.09 | Facility | None | $120.23 | $144.54 | $229.09 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $120.23 Median $131.83 Typical High $223.87 | Professional | None | $120.23 | $131.83 | $223.87 |
Providence Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $223.87 | Facility | None | $128.82 | $128.82 | $223.87 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $186.21 | Professional | None | $79.43 | $123.03 | $186.21 |
United Setting Professional Modifier None Typical Low $120.23 Median $158.49 Typical High $204.17 | Professional | None | $120.23 | $158.49 | $204.17 |
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 $33.88 Median $51.29 Typical High $81.28 | Professional | 52 · Reduced service | $33.88 | $51.29 | $81.28 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $15.49 Typical High $24.55 | Professional | 55 · Aftercare only | $10.23 | $15.49 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.23 Typical High $16.22 | Professional | 56 · Pre-op care only | $6.92 | $10.23 | $16.22 |
Where Montana sits
The same service costs 2.8 times more in Alaska than in Washington, DC. 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· 16th of 51
$132
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.