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 $281.84 Median $309.03 Typical High $346.74 | Professional | None | $281.84 | $309.03 | $346.74 |
BCBS Montana Setting Facility Modifier None Typical Low $181.97 Median $239.88 Typical High $354.81 | Facility | None | $181.97 | $239.88 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $524.81 | Facility | None | $295.12 | $295.12 | $524.81 |
Cigna Setting Professional Modifier None Typical Low $281.84 Median $295.12 Typical High $295.12 | Professional | None | $281.84 | $295.12 | $295.12 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $269.15 Median $338.84 Typical High $436.52 | Facility | None | $269.15 | $338.84 | $436.52 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $269.15 Median $346.74 Typical High $380.19 | Professional | None | $269.15 | $346.74 | $380.19 |
Providence Setting Facility Modifier None Typical Low $295.12 Median $295.12 Typical High $524.81 | Facility | None | $295.12 | $295.12 | $524.81 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $295.12 Typical High $354.81 | Professional | None | $79.43 | $295.12 | $354.81 |
United Setting Professional Modifier None Typical Low $269.15 Median $269.15 Typical High $269.15 | Professional | None | $269.15 | $269.15 | $269.15 |
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 $138.04 Median $162.18 Typical High $173.78 | Professional | 52 · Reduced service | $138.04 | $162.18 | $173.78 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $56.23 Median $64.57 Typical High $69.18 | Professional | 53 · Discontinued | $56.23 | $64.57 | $69.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $41.69 Median $48.98 Typical High $52.48 | Professional | 55 · Aftercare only | $41.69 | $48.98 | $52.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $28.18 Median $32.36 Typical High $34.67 | Professional | 56 · Pre-op care only | $28.18 | $32.36 | $34.67 |
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· 6th of 51
$295
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.