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 $85.11 Median $100.00 Typical High $107.15 | Professional | None | $85.11 | $100.00 | $107.15 |
BCBS Montana Setting Facility Modifier None Typical Low $131.83 Median $154.88 Typical High $169.82 | Facility | None | $131.83 | $154.88 | $169.82 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $93.33 Typical High $93.33 | Professional | None | $85.11 | $93.33 | $93.33 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $114.82 | Facility | None | $81.28 | $102.33 | $114.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $81.28 Median $107.15 Typical High $114.82 | Professional | None | $81.28 | $107.15 | $114.82 |
Providence Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $93.33 Typical High $109.65 | Professional | None | $79.43 | $93.33 | $109.65 |
United Setting Professional Modifier None Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | None | $81.28 | $81.28 | $81.28 |
3 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 $42.66 Median $50.12 Typical High $53.70 | Professional | 52 · Reduced service | $42.66 | $50.12 | $53.70 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $19.95 Typical High $21.38 | Professional | 53 · Discontinued | $16.98 | $19.95 | $21.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $14.79 Typical High $16.22 | Professional | 55 · Aftercare only | $12.88 | $14.79 | $16.22 |
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· 4th of 51
$93.33
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.