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 $0.37 Median $0.76 Typical High $0.93 | Professional | None | $0.37 | $0.76 | $0.93 |
Cigna Setting Facility Modifier None Typical Low $1.05 Median $1.05 Typical High $1.05 | Facility | None | $1.05 | $1.05 | $1.05 |
Cigna Setting Professional Modifier None Typical Low $1.05 Median $1.05 Typical High $1.12 | Professional | None | $1.05 | $1.05 | $1.12 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $0.68 Median $0.89 Typical High $1.23 | Facility | None | $0.68 | $0.89 | $1.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $0.68 Median $0.83 Typical High $1.23 | Professional | None | $0.68 | $0.83 | $1.23 |
Providence Setting Facility Modifier None Typical Low $1.05 Median $1.05 Typical High $1.05 | Facility | None | $1.05 | $1.05 | $1.05 |
Providence Setting Professional Modifier None Typical Low $1.05 Median $1.07 Typical High $79.43 | Professional | None | $1.05 | $1.07 | $79.43 |
United Setting Professional Modifier None Typical Low $0.41 Median $0.43 Typical High $0.72 | Professional | None | $0.41 | $0.43 | $0.72 |
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 $0.06 Median $0.11 Typical High $0.14 | Professional | 55 · Aftercare only | $0.06 | $0.11 | $0.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.04 Median $0.08 Typical High $0.09 | Professional | 56 · Pre-op care only | $0.04 | $0.08 | $0.09 |
Where Montana sits
The same service costs 2.9 times more in Minnesota than in Ohio. 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· 7th of 51
$1.05
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.