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 $28.84 Median $33.11 Typical High $36.31 | Professional | None | $28.84 | $33.11 | $36.31 |
BCBS Montana Setting Facility Modifier None Typical Low $48.98 Median $74.13 Typical High $93.33 | Facility | None | $48.98 | $74.13 | $93.33 |
Cigna Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $134.90 | Facility | None | $32.36 | $32.36 | $134.90 |
Cigna Setting Professional Modifier None Typical Low $28.84 Median $32.36 Typical High $32.36 | Professional | None | $28.84 | $32.36 | $32.36 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $24.55 Median $30.90 Typical High $39.81 | Facility | None | $24.55 | $30.90 | $39.81 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $24.55 Median $32.36 Typical High $38.90 | Professional | None | $24.55 | $32.36 | $38.90 |
Providence Setting Facility Modifier None Typical Low $32.36 Median $32.36 Typical High $134.90 | Facility | None | $32.36 | $32.36 | $134.90 |
Providence Setting Professional Modifier None Typical Low $30.20 Median $36.31 Typical High $79.43 | Professional | None | $30.20 | $36.31 | $79.43 |
United Setting Professional Modifier None Typical Low $24.55 Median $24.55 Typical High $24.55 | Professional | None | $24.55 | $24.55 | $24.55 |
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 $14.45 Median $16.60 Typical High $18.20 | Professional | 52 · Reduced service | $14.45 | $16.60 | $18.20 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.75 Median $6.61 Typical High $7.24 | Professional | 53 · Discontinued | $5.75 | $6.61 | $7.24 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.37 Median $5.01 Typical High $5.37 | Professional | 55 · Aftercare only | $4.37 | $5.01 | $5.37 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.88 Median $3.31 Typical High $3.63 | Professional | 56 · Pre-op care only | $2.88 | $3.31 | $3.63 |
Where Montana sits
The same service costs 2.8 times more in Wyoming than in Arizona. 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
$32.36
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.