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 $134.90 Median $165.96 Typical High $218.78 | Professional | None | $134.90 | $165.96 | $218.78 |
Cigna Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Cigna Setting Professional Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Professional | None | $275.42 | $275.42 | $275.42 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $181.97 Median $309.03 Typical High $338.84 | Facility | None | $181.97 | $309.03 | $338.84 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $181.97 Median $309.03 Typical High $331.13 | Professional | None | $181.97 | $309.03 | $331.13 |
Providence Setting Facility Modifier None Typical Low $275.42 Median $275.42 Typical High $275.42 | Facility | None | $275.42 | $275.42 | $275.42 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $275.42 Typical High $275.42 | Professional | None | $79.43 | $275.42 | $275.42 |
United Setting Professional Modifier None Typical Low $263.03 Median $295.12 Typical High $331.13 | Professional | None | $263.03 | $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 $67.61 Median $83.18 Typical High $109.65 | Professional | 52 · Reduced service | $67.61 | $83.18 | $109.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $26.92 Median $33.11 Typical High $43.65 | Professional | 53 · Discontinued | $26.92 | $33.11 | $43.65 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $19.95 Median $25.12 Typical High $33.11 | Professional | 55 · Aftercare only | $19.95 | $25.12 | $33.11 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $13.49 Median $16.60 Typical High $21.88 | Professional | 56 · Pre-op care only | $13.49 | $16.60 | $21.88 |
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
$275
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.