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 $190.55 Median $208.93 Typical High $245.47 | Professional | None | $190.55 | $208.93 | $245.47 |
BCBS Montana Setting Facility Modifier None Typical Low $181.97 Median $213.80 Typical High $363.08 | Facility | None | $181.97 | $213.80 | $363.08 |
Cigna Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $467.74 | Facility | None | $218.78 | $218.78 | $467.74 |
Cigna Setting Professional Modifier None Typical Low $190.55 Median $218.78 Typical High $218.78 | Professional | None | $190.55 | $218.78 | $218.78 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $186.21 Median $234.42 Typical High $302.00 | Facility | None | $186.21 | $234.42 | $302.00 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $186.21 Median $239.88 Typical High $257.04 | Professional | None | $186.21 | $239.88 | $257.04 |
Providence Setting Facility Modifier None Typical Low $218.78 Median $218.78 Typical High $467.74 | Facility | None | $218.78 | $218.78 | $467.74 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $218.78 Typical High $239.88 | Professional | None | $79.43 | $218.78 | $239.88 |
United Setting Professional Modifier None Typical Low $186.21 Median $186.21 Typical High $186.21 | Professional | None | $186.21 | $186.21 | $186.21 |
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 $95.50 Median $109.65 Typical High $120.23 | Professional | 52 · Reduced service | $95.50 | $109.65 | $120.23 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $38.02 Median $44.67 Typical High $47.86 | Professional | 53 · Discontinued | $38.02 | $44.67 | $47.86 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $28.84 Median $33.11 Typical High $35.48 | Professional | 55 · Aftercare only | $28.84 | $33.11 | $35.48 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $19.05 Median $21.88 Typical High $23.99 | Professional | 56 · Pre-op care only | $19.05 | $21.88 | $23.99 |
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· 3rd of 51
$219
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.