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 $478.63 Median $549.54 Typical High $588.84 | Professional | None | $478.63 | $549.54 | $588.84 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $691.83 | Facility | None | $467.74 | $467.74 | $691.83 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $478.63 | Professional | None | $467.74 | $467.74 | $478.63 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $398.11 Median $501.19 Typical High $645.65 | Facility | None | $398.11 | $501.19 | $645.65 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $398.11 Median $524.81 Typical High $645.65 | Professional | None | $398.11 | $524.81 | $645.65 |
Providence Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $691.83 | Facility | None | $467.74 | $467.74 | $691.83 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $467.74 Typical High $512.86 | Professional | None | $79.43 | $467.74 | $512.86 |
United Setting Professional Modifier None Typical Low $398.11 Median $398.11 Typical High $398.11 | Professional | None | $398.11 | $398.11 | $398.11 |
5 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 $234.42 Median $275.42 Typical High $295.12 | Professional | 52 · Reduced service | $234.42 | $275.42 | $295.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $95.50 Median $109.65 Typical High $117.49 | Professional | 53 · Discontinued | $95.50 | $109.65 | $117.49 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $354.81 Median $416.87 Typical High $446.68 | Professional | 54 · Surgery only | $354.81 | $416.87 | $446.68 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $70.79 Median $83.18 Typical High $89.13 | Professional | 55 · Aftercare only | $70.79 | $83.18 | $89.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $47.86 Median $54.95 Typical High $58.88 | Professional | 56 · Pre-op care only | $47.86 | $54.95 | $58.88 |
Where Montana sits
The same service costs 1.8 times more in Wyoming than in North Carolina. 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· 48th of 51
$468
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.