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 $40.74 Median $43.65 Typical High $43.65 | Professional | None | $40.74 | $43.65 | $43.65 |
Cigna Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $30.20 Median $54.95 Typical High $54.95 | Professional | None | $30.20 | $54.95 | $54.95 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $34.67 Median $51.29 Typical High $64.57 | Facility | None | $34.67 | $51.29 | $64.57 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $34.67 Median $43.65 Typical High $60.26 | Professional | None | $34.67 | $43.65 | $60.26 |
Providence Setting Facility Modifier None Typical Low $54.95 Median $54.95 Typical High $54.95 | Facility | None | $54.95 | $54.95 | $54.95 |
Providence Setting Professional Modifier None Typical Low $33.88 Median $54.95 Typical High $79.43 | Professional | None | $33.88 | $54.95 | $79.43 |
United Setting Professional Modifier None Typical Low $40.74 Median $40.74 Typical High $40.74 | Professional | None | $40.74 | $40.74 | $40.74 |
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 $20.42 Median $21.88 Typical High $21.88 | Professional | 52 · Reduced service | $20.42 | $21.88 | $21.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.13 Median $8.71 Typical High $8.71 | Professional | 53 · Discontinued | $8.13 | $8.71 | $8.71 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.17 Median $6.46 Typical High $6.61 | Professional | 55 · Aftercare only | $6.17 | $6.46 | $6.61 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.07 Median $4.37 Typical High $4.37 | Professional | 56 · Pre-op care only | $4.07 | $4.37 | $4.37 |
Where Montana sits
The same service costs 2.0 times more in Alaska than in New Mexico. 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
$51.29
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.