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 $30.20 Median $32.36 Typical High $37.15 | Professional | None | $30.20 | $32.36 | $37.15 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $46.77 | Professional | None | $25.70 | $25.70 | $46.77 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
5 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 $15.14 Median $16.22 Typical High $18.20 | Professional | 52 · Reduced service | $15.14 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.03 Median $6.46 Typical High $7.41 | Professional | 53 · Discontinued | $6.03 | $6.46 | $7.41 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.90 Typical High $5.50 | Professional | 55 · Aftercare only | $4.47 | $4.90 | $5.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.02 Median $3.24 Typical High $3.72 | Professional | 56 · Pre-op care only | $3.02 | $3.24 | $3.72 |
MountainHealth Co-op Setting Facility Modifier CSTM-00 Typical Low $229.09 Median $229.09 Typical High $331.13 | Facility | CSTM-00 | $229.09 | $229.09 | $331.13 |
Where Montana sits
The same service costs 3.1 times more in Montana than in Mississippi. 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· 1st of 51
$79.43
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.