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 $77.62 Median $117.49 Typical High $162.18 | Professional | None | $77.62 | $117.49 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Professional | None | $190.55 | $190.55 | $190.55 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $120.23 Median $204.17 Typical High $223.87 | Facility | None | $120.23 | $204.17 | $223.87 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $120.23 Median $204.17 Typical High $218.78 | Professional | None | $120.23 | $204.17 | $218.78 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $190.55 | Facility | None | $190.55 | $190.55 | $190.55 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $190.55 | Professional | None | $79.43 | $190.55 | $190.55 |
United Setting Professional Modifier None Typical Low $194.98 Median $208.93 Typical High $239.88 | Professional | None | $194.98 | $208.93 | $239.88 |
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 $38.90 Median $57.54 Typical High $81.28 | Professional | 52 · Reduced service | $38.90 | $57.54 | $81.28 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $23.44 Typical High $33.11 | Professional | 53 · Discontinued | $15.49 | $23.44 | $33.11 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.48 Median $17.38 Typical High $24.55 | Professional | 55 · Aftercare only | $11.48 | $17.38 | $24.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $11.75 Typical High $16.22 | Professional | 56 · Pre-op care only | $7.76 | $11.75 | $16.22 |
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· 4th of 51
$191
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.