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 $162.18 Median $199.53 Typical High $269.15 | Professional | None | $162.18 | $199.53 | $269.15 |
Cigna Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $218.78 Median $371.54 Typical High $407.38 | Facility | None | $218.78 | $371.54 | $407.38 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $218.78 Median $371.54 Typical High $398.11 | Professional | None | $218.78 | $371.54 | $398.11 |
Providence Setting Facility Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Facility | None | $323.59 | $323.59 | $323.59 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $323.59 Typical High $323.59 | Professional | None | $79.43 | $323.59 | $323.59 |
United Setting Professional Modifier None Typical Low $323.59 Median $363.08 Typical High $407.38 | Professional | None | $323.59 | $363.08 | $407.38 |
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 $81.28 Median $100.00 Typical High $134.90 | Professional | 52 · Reduced service | $81.28 | $100.00 | $134.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $32.36 Median $39.81 Typical High $53.70 | Professional | 53 · Discontinued | $32.36 | $39.81 | $53.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $24.55 Median $29.51 Typical High $40.74 | Professional | 55 · Aftercare only | $24.55 | $29.51 | $40.74 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $16.22 Median $19.95 Typical High $26.92 | Professional | 56 · Pre-op care only | $16.22 | $19.95 | $26.92 |
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
$324
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.