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 $28.18 Median $35.48 Typical High $46.77 | Professional | None | $28.18 | $35.48 | $46.77 |
Cigna Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Cigna Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $50.12 | Professional | None | $42.66 | $42.66 | $50.12 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $27.54 Median $38.02 Typical High $54.95 | Facility | None | $27.54 | $38.02 | $54.95 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $24.55 Median $38.02 Typical High $53.70 | Professional | None | $24.55 | $38.02 | $53.70 |
Providence Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Facility | None | $42.66 | $42.66 | $42.66 |
Providence Setting Professional Modifier None Typical Low $28.18 Median $42.66 Typical High $66.07 | Professional | None | $28.18 | $42.66 | $66.07 |
United Setting Professional Modifier None Typical Low $38.90 Median $47.86 Typical High $57.54 | Professional | None | $38.90 | $47.86 | $57.54 |
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 $14.45 Median $18.62 Typical High $24.55 | Professional | 52 · Reduced service | $14.45 | $18.62 | $24.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $7.41 Typical High $9.77 | Professional | 53 · Discontinued | $5.75 | $7.41 | $9.77 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.27 Median $5.62 Typical High $7.24 | Professional | 55 · Aftercare only | $4.27 | $5.62 | $7.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.72 Typical High $4.90 | Professional | 56 · Pre-op care only | $2.88 | $3.72 | $4.90 |
Where Montana sits
The same service costs 3.8 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· 8th of 51
$42.66
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.