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 $295.12 Median $346.74 Typical High $446.68 | Professional | None | $295.12 | $346.74 | $446.68 |
BCBS Montana Setting Professional Modifier None Typical Low $562.34 Median $630.96 Typical High $724.44 | Professional | None | $562.34 | $630.96 | $724.44 |
Cigna Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Cigna Setting Professional Modifier None Typical Low $630.96 Median $630.96 Typical High $724.44 | Professional | None | $630.96 | $630.96 | $724.44 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $457.09 Median $616.60 Typical High $851.14 | Facility | None | $457.09 | $616.60 | $851.14 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $398.11 Median $616.60 Typical High $831.76 | Professional | None | $398.11 | $616.60 | $831.76 |
Providence Setting Facility Modifier None Typical Low $630.96 Median $630.96 Typical High $630.96 | Facility | None | $630.96 | $630.96 | $630.96 |
Providence Setting Professional Modifier None Typical Low $302.00 Median $501.19 Typical High $724.44 | Professional | None | $302.00 | $501.19 | $724.44 |
United Setting Professional Modifier None Typical Low $426.58 Median $537.03 Typical High $724.44 | Professional | None | $426.58 | $537.03 | $724.44 |
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 $173.78 Median $204.17 Typical High $229.09 | Professional | 52 · Reduced service | $173.78 | $204.17 | $229.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $70.79 Median $81.28 Typical High $91.20 | Professional | 53 · Discontinued | $70.79 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $52.48 Median $61.66 Typical High $69.18 | Professional | 55 · Aftercare only | $52.48 | $61.66 | $69.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $34.67 Median $40.74 Typical High $45.71 | Professional | 56 · Pre-op care only | $34.67 | $40.74 | $45.71 |
Where Montana sits
The same service costs 2.1 times more in Wyoming than in Maryland. 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
$575
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.