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 $131.83 Median $199.53 Typical High $281.84 | Professional | None | $131.83 | $199.53 | $281.84 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $218.78 Median $371.54 Typical High $407.38 | Facility | None | $218.78 | $371.54 | $407.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $398.11 | Professional | None | $218.78 | $371.54 | $398.11 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $323.59 Typical High $323.59 | Professional | None | $79.43 | $323.59 | $323.59 |
United Setting Professional Modifier None Typical Low $331.13 Median $363.08 Typical High $407.38 | Professional | None | $331.13 | $363.08 | $407.38 |
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 $66.07 Median $100.00 Typical High $141.25 | Professional | 52 · Reduced service | $66.07 | $100.00 | $141.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.30 Median $39.81 Typical High $56.23 | Professional | 53 · Discontinued | $26.30 | $39.81 | $56.23 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $30.20 Typical High $42.66 | Professional | 55 · Aftercare only | $19.95 | $30.20 | $42.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.18 Median $19.95 Typical High $28.18 | Professional | 56 · Pre-op care only | $13.18 | $19.95 | $28.18 |
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
$324
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.