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 $104.71 Median $123.03 Typical High $131.83 | Professional | None | $104.71 | $123.03 | $131.83 |
Cigna Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $537.03 | Facility | None | $190.55 | $190.55 | $537.03 |
Cigna Setting Professional Modifier None Typical Low $104.71 Median $190.55 Typical High $190.55 | Professional | None | $104.71 | $190.55 | $190.55 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $104.71 Median $131.83 Typical High $194.98 | Facility | None | $104.71 | $131.83 | $194.98 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $120.23 Median $141.25 Typical High $151.36 | Professional | None | $120.23 | $141.25 | $151.36 |
Providence Setting Facility Modifier None Typical Low $190.55 Median $190.55 Typical High $537.03 | Facility | None | $190.55 | $190.55 | $537.03 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $134.90 Typical High $190.55 | Professional | None | $79.43 | $134.90 | $190.55 |
United Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None | $120.23 | $120.23 | $120.23 |
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 $52.48 Median $60.26 Typical High $66.07 | Professional | 52 · Reduced service | $52.48 | $60.26 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $20.89 Median $24.55 Typical High $26.30 | Professional | 53 · Discontinued | $20.89 | $24.55 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $18.20 Typical High $19.50 | Professional | 55 · Aftercare only | $15.85 | $18.20 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $12.30 Typical High $13.18 | Professional | 56 · Pre-op care only | $10.47 | $12.30 | $13.18 |
Where Montana sits
The same service costs 1.9 times more in Wyoming than in Vermont. 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· 5th of 51
$135
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.