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 $33.11 Median $47.86 Typical High $70.79 | Professional | None | $33.11 | $47.86 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $48.98 Median $85.11 Typical High $91.20 | Facility | None | $48.98 | $85.11 | $91.20 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $48.98 Median $85.11 Typical High $91.20 | Professional | None | $48.98 | $85.11 | $91.20 |
Providence Setting Facility Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Facility | None | $77.62 | $77.62 | $77.62 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $77.62 Typical High $79.43 | Professional | None | $54.95 | $77.62 | $79.43 |
United Setting Professional Modifier None Typical Low $81.28 Median $89.13 Typical High $102.33 | Professional | None | $81.28 | $89.13 | $102.33 |
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 $16.60 Median $23.99 Typical High $35.48 | Professional | 52 · Reduced service | $16.60 | $23.99 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.61 Median $9.55 Typical High $14.13 | Professional | 53 · Discontinued | $6.61 | $9.55 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $7.24 Typical High $10.47 | Professional | 55 · Aftercare only | $4.90 | $7.24 | $10.47 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.31 Median $4.79 Typical High $7.08 | Professional | 56 · Pre-op care only | $3.31 | $4.79 | $7.08 |
Where Montana sits
The same service costs 2.2 times more in Alaska than in Arizona. 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
$77.62
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.