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 $61.66 Median $75.86 Typical High $104.71 | Professional | None | $61.66 | $75.86 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Professional | None | $123.03 | $123.03 | $123.03 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $81.28 Median $138.04 Typical High $151.36 | Facility | None | $81.28 | $138.04 | $151.36 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $81.28 Median $138.04 Typical High $147.91 | Professional | None | $81.28 | $138.04 | $147.91 |
Providence Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $123.03 Typical High $123.03 | Professional | None | $79.43 | $123.03 | $123.03 |
United Setting Professional Modifier None Typical Low $123.03 Median $138.04 Typical High $154.88 | Professional | None | $123.03 | $138.04 | $154.88 |
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 $30.90 Median $37.15 Typical High $52.48 | Professional | 52 · Reduced service | $30.90 | $37.15 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.30 Median $15.14 Typical High $20.89 | Professional | 53 · Discontinued | $12.30 | $15.14 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.12 Median $11.22 Typical High $15.49 | Professional | 55 · Aftercare only | $9.12 | $11.22 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.17 Median $7.59 Typical High $10.47 | Professional | 56 · Pre-op care only | $6.17 | $7.59 | $10.47 |
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· 4th of 51
$123
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.