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 $331.13 Median $380.19 Typical High $416.87 | Professional | None | $331.13 | $380.19 | $416.87 |
Cigna Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $331.13 Median $380.19 Typical High $380.19 | Professional | None | $331.13 | $380.19 | $380.19 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $323.59 Median $407.38 Typical High $446.68 | Facility | None | $323.59 | $407.38 | $446.68 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $323.59 Median $416.87 Typical High $446.68 | Professional | None | $323.59 | $416.87 | $446.68 |
Providence Setting Facility Modifier None Typical Low $380.19 Median $380.19 Typical High $380.19 | Facility | None | $380.19 | $380.19 | $380.19 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $380.19 Typical High $416.87 | Professional | None | $79.43 | $380.19 | $416.87 |
United Setting Professional Modifier None Typical Low $323.59 Median $323.59 Typical High $323.59 | Professional | None | $323.59 | $323.59 | $323.59 |
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 $165.96 Median $190.55 Typical High $204.17 | Professional | 52 · Reduced service | $165.96 | $190.55 | $204.17 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $66.07 Median $75.86 Typical High $83.18 | Professional | 53 · Discontinued | $66.07 | $75.86 | $83.18 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $48.98 Median $57.54 Typical High $61.66 | Professional | 55 · Aftercare only | $48.98 | $57.54 | $61.66 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $33.11 Median $38.02 Typical High $41.69 | Professional | 56 · Pre-op care only | $33.11 | $38.02 | $41.69 |
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· 2nd of 51
$380
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.