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 $2.14 Median $2.14 Typical High $2.69 | Professional | None | $2.14 | $2.14 | $2.69 |
BCBS Setting Facility Modifier None Typical Low $3.89 Median $5.01 Typical High $6.31 | Facility | None | $3.89 | $5.01 | $6.31 |
Cigna Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $5.50 | Facility | None | $3.55 | $3.55 | $5.50 |
Cigna Setting Professional Modifier None Typical Low $2.14 Median $3.55 Typical High $3.55 | Professional | None | $2.14 | $3.55 | $3.55 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2.00 Median $2.51 Typical High $2.88 | Facility | None | $2.00 | $2.51 | $2.88 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.00 Median $2.63 Typical High $2.88 | Professional | None | $2.00 | $2.63 | $2.88 |
Providence Setting Facility Modifier None Typical Low $3.55 Median $3.55 Typical High $5.50 | Facility | None | $3.55 | $3.55 | $5.50 |
Providence Setting Professional Modifier None Typical Low $2.69 Median $3.55 Typical High $79.43 | Professional | None | $2.69 | $3.55 | $79.43 |
United Setting Professional Modifier None Typical Low $2.19 Median $2.19 Typical High $2.19 | Professional | None | $2.19 | $2.19 | $2.19 |
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 $1.07 Median $1.23 Typical High $1.32 | Professional | 52 · Reduced service | $1.07 | $1.23 | $1.32 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.43 Median $0.49 Typical High $0.52 | Professional | 53 · Discontinued | $0.43 | $0.49 | $0.52 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.32 Median $0.37 Typical High $0.40 | Professional | 55 · Aftercare only | $0.32 | $0.37 | $0.40 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.21 Median $0.25 Typical High $0.27 | Professional | 56 · Pre-op care only | $0.21 | $0.25 | $0.27 |
Where Montana sits
The same service costs 1.9 times more in Wyoming than in Pennsylvania. 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· 4th of 51
$2.69
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.