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 $63.10 Median $72.44 Typical High $79.43 | Professional | None | $63.10 | $72.44 | $79.43 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $109.65 | Facility | None | $57.54 | $57.54 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $63.10 | Professional | None | $57.54 | $57.54 | $63.10 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $57.54 Median $70.79 Typical High $85.11 | Facility | None | $57.54 | $70.79 | $85.11 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $85.11 | Professional | None | $57.54 | $75.86 | $85.11 |
Providence Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $109.65 | Facility | None | $57.54 | $57.54 | $109.65 |
Providence Setting Professional Modifier None Typical Low $57.54 Median $67.61 Typical High $79.43 | Professional | None | $57.54 | $67.61 | $79.43 |
United Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Professional | None | $57.54 | $57.54 | $57.54 |
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 $31.62 Median $36.31 Typical High $38.90 | Professional | 52 · Reduced service | $31.62 | $36.31 | $38.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $14.45 Typical High $15.85 | Professional | 53 · Discontinued | $12.59 | $14.45 | $15.85 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $10.96 Typical High $11.75 | Professional | 55 · Aftercare only | $9.33 | $10.96 | $11.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $7.24 Typical High $7.94 | Professional | 56 · Pre-op care only | $6.31 | $7.24 | $7.94 |
Where Montana sits
Rates are fairly even across states for this service. 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· 18th of 51
$63.10
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.