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 $24.55 Median $48.98 Typical High $61.66 | Professional | None | $24.55 | $48.98 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $69.18 Typical High $69.18 | Professional | None | $38.02 | $69.18 | $69.18 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $43.65 Median $64.57 Typical High $81.28 | Facility | None | $43.65 | $64.57 | $81.28 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $43.65 Median $54.95 Typical High $81.28 | Professional | None | $43.65 | $54.95 | $81.28 |
Providence Setting Facility Modifier None Typical Low $69.18 Median $69.18 Typical High $69.18 | Facility | None | $69.18 | $69.18 | $69.18 |
Providence Setting Professional Modifier None Typical Low $46.77 Median $69.18 Typical High $79.43 | Professional | None | $46.77 | $69.18 | $79.43 |
United Setting Professional Modifier None Typical Low $26.30 Median $28.84 Typical High $47.86 | Professional | None | $26.30 | $28.84 | $47.86 |
2 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 55 · Aftercare only Typical Low $3.72 Median $7.41 Typical High $9.33 | Professional | 55 · Aftercare only | $3.72 | $7.41 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.45 Median $4.90 Typical High $6.17 | Professional | 56 · Pre-op care only | $2.45 | $4.90 | $6.17 |
Where Montana sits
The same service costs 3.0 times more in Montana 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· 1st of 51
$69.18
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.