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 $36.31 Median $40.74 Typical High $45.71 | Professional | None | $36.31 | $40.74 | $45.71 |
BCBS Montana Setting Facility Modifier None Typical Low $36.31 Median $36.31 Typical High $70.79 | Facility | None | $36.31 | $36.31 | $70.79 |
Cigna Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Cigna Setting Professional Modifier None Typical Low $36.31 Median $44.67 Typical High $44.67 | Professional | None | $36.31 | $44.67 | $44.67 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $36.31 Median $45.71 Typical High $50.12 | Facility | None | $36.31 | $45.71 | $50.12 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $37.15 Median $45.71 Typical High $48.98 | Professional | None | $37.15 | $45.71 | $48.98 |
Providence Setting Facility Modifier None Typical Low $44.67 Median $44.67 Typical High $44.67 | Facility | None | $44.67 | $44.67 | $44.67 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $46.77 Typical High $79.43 | Professional | None | $44.67 | $46.77 | $79.43 |
United Setting Professional Modifier None Typical Low $36.31 Median $36.31 Typical High $36.31 | Professional | None | $36.31 | $36.31 | $36.31 |
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 $18.20 Median $21.38 Typical High $22.91 | Professional | 52 · Reduced service | $18.20 | $21.38 | $22.91 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.41 Median $8.51 Typical High $9.12 | Professional | 53 · Discontinued | $7.41 | $8.51 | $9.12 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.50 Median $6.31 Typical High $6.92 | Professional | 55 · Aftercare only | $5.50 | $6.31 | $6.92 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $4.27 Typical High $4.57 | Professional | 56 · Pre-op care only | $3.63 | $4.27 | $4.57 |
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
$44.67
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.