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 $17.38 Median $53.70 Typical High $144.54 | Professional | None | $17.38 | $53.70 | $144.54 |
Cigna Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Cigna Setting Professional Modifier None Typical Low $33.88 Median $74.13 Typical High $131.83 | Professional | None | $33.88 | $74.13 | $131.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $23.99 Median $40.74 Typical High $141.25 | Facility | None | $23.99 | $40.74 | $141.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $20.89 Median $34.67 Typical High $138.04 | Professional | None | $20.89 | $34.67 | $138.04 |
Providence Setting Facility Modifier None Typical Low $33.88 Median $33.88 Typical High $33.88 | Facility | None | $33.88 | $33.88 | $33.88 |
Providence Setting Professional Modifier None Typical Low $21.88 Median $79.43 Typical High $131.83 | Professional | None | $21.88 | $79.43 | $131.83 |
United Setting Professional Modifier None Typical Low $33.11 Median $52.48 Typical High $138.04 | Professional | None | $33.11 | $52.48 | $138.04 |
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 $8.71 Median $26.92 Typical High $72.44 | Professional | 52 · Reduced service | $8.71 | $26.92 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $10.72 Typical High $28.84 | Professional | 53 · Discontinued | $3.47 | $10.72 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.63 Median $7.94 Typical High $21.88 | Professional | 55 · Aftercare only | $2.63 | $7.94 | $21.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $5.37 Typical High $14.45 | Professional | 56 · Pre-op care only | $1.74 | $5.37 | $14.45 |
Where Montana sits
The same service costs 6.5 times more in Alaska than in Indiana. 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· 7th of 51
$79.43
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.