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 $34.67 Median $60.26 Typical High $75.86 | Professional | None | $34.67 | $60.26 | $75.86 |
BCBS Montana Setting Professional Modifier None Typical Low $5.89 Median $5.89 Typical High $5.89 | Professional | None | $5.89 | $5.89 | $5.89 |
Cigna Setting Facility Modifier None Typical Low $70.79 Median $75.86 Typical High $75.86 | Facility | None | $70.79 | $75.86 | $75.86 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $75.86 Typical High $75.86 | Professional | None | $52.48 | $75.86 | $75.86 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $64.57 Median $79.43 Typical High $3,715.35 | Facility | None | $64.57 | $79.43 | $3,715.35 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $64.57 Median $79.43 Typical High $3,890.45 | Professional | None | $64.57 | $79.43 | $3,890.45 |
Providence Setting Facility Modifier None Typical Low $43.65 Median $75.86 Typical High $75.86 | Facility | None | $43.65 | $75.86 | $75.86 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $75.86 Typical High $79.43 | Professional | None | $53.70 | $75.86 | $79.43 |
United Setting Professional Modifier None Typical Low $30.20 Median $30.20 Typical High $50.12 | Professional | None | $30.20 | $30.20 | $50.12 |
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 $5.25 Median $8.91 Typical High $11.48 | Professional | 55 · Aftercare only | $5.25 | $8.91 | $11.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.47 Median $7.59 Typical High $7.59 | Professional | 56 · Pre-op care only | $3.47 | $7.59 | $7.59 |
Where Montana sits
The same service costs 2.6 times more in Wyoming 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· 5th of 51
$75.86
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.