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 $245.47 Median $489.78 Typical High $616.60 | Professional | None | $245.47 | $489.78 | $616.60 |
Cigna Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $371.54 Median $691.83 Typical High $691.83 | Professional | None | $371.54 | $691.83 | $691.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $436.52 Median $645.65 Typical High $812.83 | Facility | None | $436.52 | $645.65 | $812.83 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $436.52 Median $549.54 Typical High $794.33 | Professional | None | $436.52 | $549.54 | $794.33 |
Providence Setting Facility Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Facility | None | $691.83 | $691.83 | $691.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $630.96 Typical High $707.95 | Professional | None | $79.43 | $630.96 | $707.95 |
United Setting Professional Modifier None Typical Low $257.04 Median $281.84 Typical High $467.74 | Professional | None | $257.04 | $281.84 | $467.74 |
4 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 $123.03 Median $245.47 Typical High $309.03 | Professional | 52 · Reduced service | $123.03 | $245.47 | $309.03 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $48.98 Median $97.72 Typical High $123.03 | Professional | 53 · Discontinued | $48.98 | $97.72 | $123.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $36.31 Median $72.44 Typical High $93.33 | Professional | 55 · Aftercare only | $36.31 | $72.44 | $93.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $24.55 Median $48.98 Typical High $61.66 | Professional | 56 · Pre-op care only | $24.55 | $48.98 | $61.66 |
Where Montana sits
The same service costs 17.0 times more in Iowa 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· 2nd of 51
$603
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.