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 $295.12 Median $316.23 Typical High $316.23 | Professional | None | $295.12 | $316.23 | $316.23 |
Cigna Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $457.09 | Facility | None | $204.17 | $204.17 | $457.09 |
Cigna Setting Professional Modifier None Typical Low $204.17 Median $204.17 Typical High $323.59 | Professional | None | $204.17 | $204.17 | $323.59 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $131.83 Median $177.83 Typical High $245.47 | Facility | None | $131.83 | $177.83 | $245.47 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $131.83 Median $162.18 Typical High $223.87 | Professional | None | $131.83 | $162.18 | $223.87 |
Providence Setting Facility Modifier None Typical Low $204.17 Median $204.17 Typical High $457.09 | Facility | None | $204.17 | $204.17 | $457.09 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $190.55 Typical High $213.80 | Professional | None | $79.43 | $190.55 | $213.80 |
United Setting Professional Modifier None Typical Low $309.03 Median $309.03 Typical High $309.03 | Professional | None | $309.03 | $309.03 | $309.03 |
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 $147.91 Median $158.49 Typical High $158.49 | Professional | 52 · Reduced service | $147.91 | $158.49 | $158.49 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $58.88 Median $63.10 Typical High $64.57 | Professional | 53 · Discontinued | $58.88 | $63.10 | $64.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $44.67 Median $47.86 Typical High $47.86 | Professional | 55 · Aftercare only | $44.67 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $29.51 Median $31.62 Typical High $31.62 | Professional | 56 · Pre-op care only | $29.51 | $31.62 | $31.62 |
Where Montana sits
The same service costs 2.3 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
$204
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.