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 $18.62 Median $31.62 Typical High $34.67 | Professional | None | $18.62 | $31.62 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $22.91 Median $38.90 Typical High $42.66 | Facility | None | $22.91 | $38.90 | $42.66 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $22.91 Median $28.84 Typical High $41.69 | Professional | None | $22.91 | $28.84 | $41.69 |
Providence Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Facility | None | $36.31 | $36.31 | $36.31 |
Providence Setting Professional Modifier None Typical Low $22.39 Median $36.31 Typical High $79.43 | Professional | None | $22.39 | $36.31 | $79.43 |
United Setting Professional Modifier None Typical Low $33.88 Median $40.74 Typical High $45.71 | Professional | None | $33.88 | $40.74 | $45.71 |
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 $9.33 Median $15.85 Typical High $17.38 | Professional | 52 · Reduced service | $9.33 | $15.85 | $17.38 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.72 Median $6.31 Typical High $7.08 | Professional | 53 · Discontinued | $3.72 | $6.31 | $7.08 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.82 Median $4.68 Typical High $5.25 | Professional | 55 · Aftercare only | $2.82 | $4.68 | $5.25 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.86 Median $3.16 Typical High $3.47 | Professional | 56 · Pre-op care only | $1.86 | $3.16 | $3.47 |
Where Montana sits
The same service costs 2.7 times more in Alaska than in Connecticut. 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· 8th of 51
$36.31
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.