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 $5.75 Median $6.61 Typical High $7.08 | Professional | None | $5.75 | $6.61 | $7.08 |
Cigna Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $16.98 | Facility | None | $7.08 | $7.08 | $16.98 |
Cigna Setting Professional Modifier None Typical Low $5.50 Median $7.08 Typical High $7.08 | Professional | None | $5.50 | $7.08 | $7.08 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $5.62 Median $7.08 Typical High $11.48 | Facility | None | $5.62 | $7.08 | $11.48 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5.62 Median $6.31 Typical High $7.08 | Professional | None | $5.62 | $6.31 | $7.08 |
Providence Setting Facility Modifier None Typical Low $7.08 Median $7.08 Typical High $16.98 | Facility | None | $7.08 | $7.08 | $16.98 |
Providence Setting Professional Modifier None Typical Low $5.50 Median $7.08 Typical High $9.12 | Professional | None | $5.50 | $7.08 | $9.12 |
United Setting Professional Modifier None Typical Low $5.75 Median $5.75 Typical High $5.75 | Professional | None | $5.75 | $5.75 | $5.75 |
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 $2.88 Median $3.31 Typical High $3.55 | Professional | 52 · Reduced service | $2.88 | $3.31 | $3.55 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.15 Median $1.32 Typical High $1.45 | Professional | 53 · Discontinued | $1.15 | $1.32 | $1.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.85 Median $1.00 Typical High $1.07 | Professional | 55 · Aftercare only | $0.85 | $1.00 | $1.07 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.56 Median $0.68 Typical High $0.72 | Professional | 56 · Pre-op care only | $0.56 | $0.68 | $0.72 |
Where Montana sits
The same service costs 1.5 times more in Alaska than in Pennsylvania. 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
$7.08
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.