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 $7.24 Median $13.18 Typical High $23.44 | Professional | None | $7.24 | $13.18 | $23.44 |
BCBS Montana Setting Professional Modifier None Typical Low $13.80 Median $31.62 Typical High $37.15 | Professional | None | $13.80 | $31.62 | $37.15 |
Cigna Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Cigna Setting Professional Modifier None Typical Low $13.80 Median $22.39 Typical High $37.15 | Professional | None | $13.80 | $22.39 | $37.15 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $8.91 Median $16.60 Typical High $42.66 | Facility | None | $8.91 | $16.60 | $42.66 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $8.51 Median $14.13 Typical High $41.69 | Professional | None | $8.51 | $14.13 | $41.69 |
Providence Setting Facility Modifier None Typical Low $13.80 Median $13.80 Typical High $13.80 | Facility | None | $13.80 | $13.80 | $13.80 |
Providence Setting Professional Modifier None Typical Low $9.12 Median $21.88 Typical High $38.90 | Professional | None | $9.12 | $21.88 | $38.90 |
United Setting Professional Modifier None Typical Low $12.88 Median $21.88 Typical High $38.90 | Professional | None | $12.88 | $21.88 | $38.90 |
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 $1.07 Median $2.00 Typical High $3.55 | Professional | 55 · Aftercare only | $1.07 | $2.00 | $3.55 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.72 Median $1.32 Typical High $2.34 | Professional | 56 · Pre-op care only | $0.72 | $1.32 | $2.34 |
Where Montana sits
The same service costs 3.8 times more in Alaska than in Washington, DC. 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· 23rd of 51
$21.88
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.