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 $123.03 Median $158.49 Typical High $223.87 | Professional | None | $123.03 | $158.49 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Cigna Setting Professional Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Professional | None | $251.19 | $251.19 | $251.19 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $162.18 Median $281.84 Typical High $302.00 | Facility | None | $162.18 | $281.84 | $302.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $162.18 Median $281.84 Typical High $302.00 | Professional | None | $162.18 | $281.84 | $302.00 |
Providence Setting Facility Modifier None Typical Low $251.19 Median $251.19 Typical High $251.19 | Facility | None | $251.19 | $251.19 | $251.19 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $251.19 Typical High $251.19 | Professional | None | $79.43 | $251.19 | $251.19 |
United Setting Professional Modifier None Typical Low $269.15 Median $295.12 Typical High $331.13 | Professional | None | $269.15 | $295.12 | $331.13 |
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 $61.66 Median $79.43 Typical High $112.20 | Professional | 52 · Reduced service | $61.66 | $79.43 | $112.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $25.12 Median $32.36 Typical High $44.67 | Professional | 53 · Discontinued | $25.12 | $32.36 | $44.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $18.62 Median $23.99 Typical High $33.88 | Professional | 55 · Aftercare only | $18.62 | $23.99 | $33.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $12.30 Median $15.85 Typical High $22.39 | Professional | 56 · Pre-op care only | $12.30 | $15.85 | $22.39 |
Where Montana sits
The same service costs 2.6 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· 5th of 51
$251
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.