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 $38.02 Median $66.07 Typical High $104.71 | Professional | None | $38.02 | $66.07 | $104.71 |
Cigna Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Cigna Setting Professional Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Professional | None | $72.44 | $72.44 | $72.44 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $46.77 Median $79.43 Typical High $87.10 | Facility | None | $46.77 | $79.43 | $87.10 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $46.77 Median $57.54 Typical High $85.11 | Professional | None | $46.77 | $57.54 | $85.11 |
Providence Setting Facility Modifier None Typical Low $72.44 Median $72.44 Typical High $72.44 | Facility | None | $72.44 | $72.44 | $72.44 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $72.44 Typical High $79.43 | Professional | None | $44.67 | $72.44 | $79.43 |
United Setting Professional Modifier None Typical Low $67.61 Median $81.28 Typical High $91.20 | Professional | None | $67.61 | $81.28 | $91.20 |
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 $19.05 Median $33.11 Typical High $52.48 | Professional | 52 · Reduced service | $19.05 | $33.11 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $13.18 Typical High $20.89 | Professional | 53 · Discontinued | $7.59 | $13.18 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.62 Median $10.00 Typical High $15.85 | Professional | 55 · Aftercare only | $5.62 | $10.00 | $15.85 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.61 Typical High $10.47 | Professional | 56 · Pre-op care only | $3.80 | $6.61 | $10.47 |
Where Montana sits
The same service costs 4.0 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· 9th of 51
$72.44
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.