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 $57.54 Median $57.54 Typical High $72.44 | Professional | None | $57.54 | $57.54 | $72.44 |
BCBS Montana Setting Facility Modifier None Typical Low $60.26 Median $63.10 Typical High $114.82 | Facility | None | $60.26 | $63.10 | $114.82 |
Cigna Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Cigna Setting Professional Modifier None Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | None | $57.54 | $64.57 | $64.57 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $54.95 Median $69.18 Typical High $77.62 | Facility | None | $54.95 | $69.18 | $77.62 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $54.95 Median $70.79 Typical High $77.62 | Professional | None | $54.95 | $70.79 | $77.62 |
Providence Setting Facility Modifier None Typical Low $64.57 Median $64.57 Typical High $64.57 | Facility | None | $64.57 | $64.57 | $64.57 |
Providence Setting Professional Modifier None Typical Low $64.57 Median $72.44 Typical High $79.43 | Professional | None | $64.57 | $72.44 | $79.43 |
United Setting Professional Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Professional | None | $54.95 | $54.95 | $54.95 |
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 $28.84 Median $33.11 Typical High $35.48 | Professional | 52 · Reduced service | $28.84 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $13.18 Typical High $14.13 | Professional | 53 · Discontinued | $11.48 | $13.18 | $14.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.51 Median $10.00 Typical High $10.72 | Professional | 55 · Aftercare only | $8.51 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.61 Typical High $7.08 | Professional | 56 · Pre-op care only | $5.75 | $6.61 | $7.08 |
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· 2nd of 51
$64.57
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.