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 $29.51 Median $31.62 Typical High $31.62 | Professional | None | $29.51 | $31.62 | $31.62 |
Cigna Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $102.33 | Facility | None | $20.42 | $20.42 | $102.33 |
Cigna Setting Professional Modifier None Typical Low $20.42 Median $20.42 Typical High $31.62 | Professional | None | $20.42 | $20.42 | $31.62 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $12.88 Median $16.22 Typical High $26.30 | Facility | None | $12.88 | $16.22 | $26.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $12.88 Median $14.45 Typical High $16.22 | Professional | None | $12.88 | $14.45 | $16.22 |
Providence Setting Facility Modifier None Typical Low $20.42 Median $20.42 Typical High $102.33 | Facility | None | $20.42 | $20.42 | $102.33 |
Providence Setting Professional Modifier None Typical Low $20.42 Median $43.65 Typical High $79.43 | Professional | None | $20.42 | $43.65 | $79.43 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
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 $14.79 Median $15.85 Typical High $15.85 | Professional | 52 · Reduced service | $14.79 | $15.85 | $15.85 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.89 Median $6.31 Typical High $6.31 | Professional | 53 · Discontinued | $5.89 | $6.31 | $6.31 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.47 Median $4.68 Typical High $4.79 | Professional | 55 · Aftercare only | $4.47 | $4.68 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.95 Median $3.16 Typical High $3.16 | Professional | 56 · Pre-op care only | $2.95 | $3.16 | $3.16 |
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· 48th of 51
$30.90
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.