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 $8,511.38 Median $8,912.51 Typical High $9,120.11 | Professional | None | $8,511.38 | $8,912.51 | $9,120.11 |
Cigna Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $1,023.29 | Facility | None | $467.74 | $467.74 | $1,023.29 |
Cigna Setting Professional Modifier None Typical Low $467.74 Median $467.74 Typical High $8,912.51 | Professional | None | $467.74 | $467.74 | $8,912.51 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $302.00 Median $436.52 Typical High $549.54 | Facility | None | $302.00 | $436.52 | $549.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $302.00 Median $371.54 Typical High $512.86 | Professional | None | $302.00 | $371.54 | $512.86 |
Providence Setting Facility Modifier None Typical Low $467.74 Median $467.74 Typical High $1,023.29 | Facility | None | $467.74 | $467.74 | $1,023.29 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $436.52 Typical High $478.63 | Professional | None | $79.43 | $436.52 | $478.63 |
United Setting Professional Modifier None Typical Low $8,709.64 Median $8,709.64 Typical High $8,709.64 | Professional | None | $8,709.64 | $8,709.64 | $8,709.64 |
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 $4,265.80 Median $4,466.84 Typical High $4,570.88 | Professional | 52 · Reduced service | $4,265.80 | $4,466.84 | $4,570.88 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1,698.24 Median $1,778.28 Typical High $1,819.70 | Professional | 53 · Discontinued | $1,698.24 | $1,778.28 | $1,819.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $1,258.93 Median $1,348.96 Typical High $1,348.96 | Professional | 55 · Aftercare only | $1,258.93 | $1,348.96 | $1,348.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $851.14 Median $891.25 Typical High $912.01 | Professional | 56 · Pre-op care only | $851.14 | $891.25 | $912.01 |
Where Montana sits
The same service costs 26.3 times more in Alaska than in Montana. 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· 51st of 51
$468
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.