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 $67.61 Median $120.23 Typical High $173.78 | Professional | None | $67.61 | $120.23 | $173.78 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Professional | None | $131.83 | $131.83 | $131.83 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $83.18 Median $141.25 Typical High $154.88 | Facility | None | $83.18 | $141.25 | $154.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $83.18 Median $104.71 Typical High $151.36 | Professional | None | $83.18 | $104.71 | $151.36 |
Providence Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $134.90 | Professional | None | $79.43 | $117.49 | $134.90 |
United Setting Professional Modifier None Typical Low $123.03 Median $144.54 Typical High $165.96 | Professional | None | $123.03 | $144.54 | $165.96 |
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 $33.88 Median $60.26 Typical High $87.10 | Professional | 52 · Reduced service | $33.88 | $60.26 | $87.10 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.49 Median $23.99 Typical High $34.67 | Professional | 53 · Discontinued | $13.49 | $23.99 | $34.67 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.23 Median $18.20 Typical High $26.30 | Professional | 55 · Aftercare only | $10.23 | $18.20 | $26.30 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.76 Median $12.02 Typical High $17.38 | Professional | 56 · Pre-op care only | $6.76 | $12.02 | $17.38 |
Where Montana sits
The same service costs 3.6 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
$132
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.