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 $4,677.35 Median $5,011.87 Typical High $5,011.87 | Professional | None | $4,677.35 | $5,011.87 | $5,011.87 |
Cigna Setting Facility Modifier None Typical Low $6,456.54 Median $7,413.10 Typical High $8,912.51 | Facility | None | $6,456.54 | $7,413.10 | $8,912.51 |
Cigna Setting Professional Modifier None Typical Low $5,011.87 Median $7,413.10 Typical High $7,413.10 | Professional | None | $5,011.87 | $7,413.10 | $7,413.10 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $4,677.35 Median $7,585.78 Typical High $9,332.54 | Facility | None | $4,677.35 | $7,585.78 | $9,332.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $4,677.35 Median $5,888.44 Typical High $8,128.31 | Professional | None | $4,677.35 | $5,888.44 | $8,128.31 |
Providence Setting Facility Modifier None Typical Low $6,456.54 Median $7,413.10 Typical High $8,912.51 | Facility | None | $6,456.54 | $7,413.10 | $8,912.51 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $6,918.31 Typical High $8,128.31 | Professional | None | $79.43 | $6,918.31 | $8,128.31 |
United Setting Professional Modifier None Typical Low $4,897.79 Median $4,897.79 Typical High $4,897.79 | Professional | None | $4,897.79 | $4,897.79 | $4,897.79 |
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 $2,344.23 Median $2,511.89 Typical High $2,511.89 | Professional | 52 · Reduced service | $2,344.23 | $2,511.89 | $2,511.89 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $933.25 Median $1,000.00 Typical High $1,000.00 | Professional | 53 · Discontinued | $933.25 | $1,000.00 | $1,000.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $707.95 Median $741.31 Typical High $758.58 | Professional | 55 · Aftercare only | $707.95 | $741.31 | $758.58 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $467.74 Median $501.19 Typical High $501.19 | Professional | 56 · Pre-op care only | $467.74 | $501.19 | $501.19 |
Where Montana sits
The same service costs 1.8 times more in Alaska than in North 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· 2nd of 51
$5,888
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.