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 $38.02 Median $44.67 Typical High $47.86 | Professional | None | $38.02 | $44.67 | $47.86 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $107.15 | Facility | None | $53.70 | $53.70 | $107.15 |
Cigna Setting Professional Modifier None Typical Low $38.02 Median $53.70 Typical High $53.70 | Professional | None | $38.02 | $53.70 | $53.70 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $38.02 Median $47.86 Typical High $79.43 | Facility | None | $38.02 | $47.86 | $79.43 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $39.81 Median $47.86 Typical High $51.29 | Professional | None | $39.81 | $47.86 | $51.29 |
Providence Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $107.15 | Facility | None | $53.70 | $53.70 | $107.15 |
Providence Setting Professional Modifier None Typical Low $48.98 Median $53.70 Typical High $79.43 | Professional | None | $48.98 | $53.70 | $79.43 |
United Setting Professional Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Professional | None | $39.81 | $39.81 | $39.81 |
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 $19.05 Median $21.88 Typical High $23.99 | Professional | 52 · Reduced service | $19.05 | $21.88 | $23.99 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.59 Median $8.91 Typical High $9.55 | Professional | 53 · Discontinued | $7.59 | $8.91 | $9.55 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.75 Median $6.61 Typical High $7.08 | Professional | 55 · Aftercare only | $5.75 | $6.61 | $7.08 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $4.47 Typical High $4.79 | Professional | 56 · Pre-op care only | $3.80 | $4.47 | $4.79 |
Where Montana sits
The same service costs 1.6 times more in Alaska than in South Carolina. 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· 5th of 51
$50.12
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.