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 $64.57 Median $100.00 Typical High $138.04 | Professional | None | $64.57 | $100.00 | $138.04 |
Cigna Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Cigna Setting Professional Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Professional | None | $162.18 | $162.18 | $162.18 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $102.33 Median $177.83 Typical High $190.55 | Facility | None | $102.33 | $177.83 | $190.55 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $102.33 Median $177.83 Typical High $190.55 | Professional | None | $102.33 | $177.83 | $190.55 |
Providence Setting Facility Modifier None Typical Low $162.18 Median $162.18 Typical High $162.18 | Facility | None | $162.18 | $162.18 | $162.18 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $162.18 Typical High $162.18 | Professional | None | $79.43 | $162.18 | $162.18 |
United Setting Professional Modifier None Typical Low $158.49 Median $177.83 Typical High $199.53 | Professional | None | $158.49 | $177.83 | $199.53 |
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 $32.36 Median $50.12 Typical High $69.18 | Professional | 52 · Reduced service | $32.36 | $50.12 | $69.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $19.95 Typical High $27.54 | Professional | 53 · Discontinued | $13.18 | $19.95 | $27.54 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $14.79 Typical High $20.89 | Professional | 55 · Aftercare only | $9.77 | $14.79 | $20.89 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $10.00 Typical High $13.80 | Professional | 56 · Pre-op care only | $6.46 | $10.00 | $13.80 |
Where Montana sits
The same service costs 2.2 times more in Alaska 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· 4th of 51
$162
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.