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 $60.26 Median $69.18 Typical High $74.13 | Professional | None | $60.26 | $69.18 | $74.13 |
BCBS Montana Setting Facility Modifier None Typical Low $89.13 Median $177.83 Typical High $275.42 | Facility | None | $89.13 | $177.83 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $346.74 | Facility | None | $144.54 | $144.54 | $346.74 |
Cigna Setting Professional Modifier None Typical Low $60.26 Median $144.54 Typical High $144.54 | Professional | None | $60.26 | $144.54 | $144.54 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $60.26 Median $77.62 Typical High $117.49 | Facility | None | $60.26 | $77.62 | $117.49 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $95.50 | Professional | None | $74.13 | $81.28 | $95.50 |
Providence Setting Facility Modifier None Typical Low $144.54 Median $144.54 Typical High $346.74 | Facility | None | $144.54 | $144.54 | $346.74 |
Providence Setting Professional Modifier None Typical Low $75.86 Median $79.43 Typical High $144.54 | Professional | None | $75.86 | $79.43 | $144.54 |
United Setting Professional Modifier None Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | None | $77.62 | $77.62 | $77.62 |
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 $30.20 Median $34.67 Typical High $37.15 | Professional | 52 · Reduced service | $30.20 | $34.67 | $37.15 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.02 Median $13.80 Typical High $15.14 | Professional | 53 · Discontinued | $12.02 | $13.80 | $15.14 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $10.47 Typical High $11.22 | Professional | 55 · Aftercare only | $8.91 | $10.47 | $11.22 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.03 Median $6.92 Typical High $7.59 | Professional | 56 · Pre-op care only | $6.03 | $6.92 | $7.59 |
Where Montana sits
The same service costs 2.6 times more in Hawaii than in Colorado. 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· 11th of 51
$79.43
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.