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 $95.50 Median $117.49 Typical High $158.49 | Professional | None | $95.50 | $117.49 | $158.49 |
Cigna Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Cigna Setting Professional Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Professional | None | $194.98 | $194.98 | $194.98 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $128.82 Median $218.78 Typical High $239.88 | Facility | None | $128.82 | $218.78 | $239.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $128.82 Median $218.78 Typical High $234.42 | Professional | None | $128.82 | $218.78 | $234.42 |
Providence Setting Facility Modifier None Typical Low $194.98 Median $194.98 Typical High $194.98 | Facility | None | $194.98 | $194.98 | $194.98 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $194.98 Typical High $194.98 | Professional | None | $79.43 | $194.98 | $194.98 |
United Setting Professional Modifier None Typical Low $190.55 Median $208.93 Typical High $234.42 | Professional | None | $190.55 | $208.93 | $234.42 |
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 $47.86 Median $58.88 Typical High $79.43 | Professional | 52 · Reduced service | $47.86 | $58.88 | $79.43 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $23.44 Typical High $31.62 | Professional | 53 · Discontinued | $19.05 | $23.44 | $31.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $17.78 Typical High $23.99 | Professional | 55 · Aftercare only | $14.45 | $17.78 | $23.99 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $11.75 Typical High $15.85 | Professional | 56 · Pre-op care only | $9.55 | $11.75 | $15.85 |
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
$195
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.