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 $45.71 Median $75.86 Typical High $93.33 | Professional | None | $45.71 | $75.86 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Cigna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | None | $87.10 | $87.10 | $87.10 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $56.23 Median $95.50 Typical High $104.71 | Facility | None | $56.23 | $95.50 | $104.71 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $56.23 Median $69.18 Typical High $102.33 | Professional | None | $56.23 | $69.18 | $102.33 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $87.10 | Facility | None | $87.10 | $87.10 | $87.10 |
Providence Setting Professional Modifier None Typical Low $53.70 Median $81.28 Typical High $89.13 | Professional | None | $53.70 | $81.28 | $89.13 |
United Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $109.65 | Professional | None | $81.28 | $97.72 | $109.65 |
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 $22.91 Median $38.02 Typical High $46.77 | Professional | 52 · Reduced service | $22.91 | $38.02 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.12 Median $15.14 Typical High $18.62 | Professional | 53 · Discontinued | $9.12 | $15.14 | $18.62 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.76 Median $11.22 Typical High $13.80 | Professional | 55 · Aftercare only | $6.76 | $11.22 | $13.80 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.57 Median $7.59 Typical High $9.33 | Professional | 56 · Pre-op care only | $4.57 | $7.59 | $9.33 |
Where Montana sits
The same service costs 3.0 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
$87.10
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.