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 $48.98 Median $52.48 Typical High $52.48 | Professional | None | $48.98 | $52.48 | $52.48 |
Cigna Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $45.71 | Facility | None | $11.22 | $11.22 | $45.71 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $11.22 Typical High $52.48 | Professional | None | $11.22 | $11.22 | $52.48 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $6.03 Median $11.22 Typical High $11.22 | Facility | None | $6.03 | $11.22 | $11.22 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $11.22 Median $12.02 Typical High $12.02 | Professional | None | $11.22 | $12.02 | $12.02 |
Providence Setting Facility Modifier None Typical Low $11.22 Median $11.22 Typical High $45.71 | Facility | None | $11.22 | $11.22 | $45.71 |
Providence Setting Professional Modifier None Typical Low $11.22 Median $20.89 Typical High $79.43 | Professional | None | $11.22 | $20.89 | $79.43 |
United Setting Professional Modifier None Typical Low $50.12 Median $50.12 Typical High $50.12 | Professional | None | $50.12 | $50.12 | $50.12 |
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 $24.55 Median $25.70 Typical High $26.30 | Professional | 52 · Reduced service | $24.55 | $25.70 | $26.30 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $9.77 Median $10.47 Typical High $10.47 | Professional | 53 · Discontinued | $9.77 | $10.47 | $10.47 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $7.41 Median $7.76 Typical High $7.94 | Professional | 55 · Aftercare only | $7.41 | $7.76 | $7.94 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.90 Median $5.25 Typical High $5.25 | Professional | 56 · Pre-op care only | $4.90 | $5.25 | $5.25 |
Where Montana sits
The same service costs 6.6 times more in Alaska than in Hawaii. 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· 50th of 51
$19.50
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.