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 $17.38 Median $17.38 Typical High $21.88 | Professional | None | $17.38 | $17.38 | $21.88 |
BCBS Montana Setting Facility Modifier None Typical Low $16.22 Median $16.22 Typical High $29.51 | Facility | None | $16.22 | $16.22 | $29.51 |
Cigna Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $38.02 | Facility | None | $19.95 | $19.95 | $38.02 |
Cigna Setting Professional Modifier None Typical Low $17.38 Median $19.95 Typical High $19.95 | Professional | None | $17.38 | $19.95 | $19.95 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $16.98 Median $21.38 Typical High $27.54 | Facility | None | $16.98 | $21.38 | $27.54 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $16.98 Median $21.38 Typical High $23.44 | Professional | None | $16.98 | $21.38 | $23.44 |
Providence Setting Facility Modifier None Typical Low $19.95 Median $19.95 Typical High $38.02 | Facility | None | $19.95 | $19.95 | $38.02 |
Providence Setting Professional Modifier None Typical Low $19.95 Median $21.88 Typical High $79.43 | Professional | None | $19.95 | $21.88 | $79.43 |
United Setting Professional Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Professional | None | $16.98 | $16.98 | $16.98 |
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 $8.51 Median $10.00 Typical High $10.72 | Professional | 52 · Reduced service | $8.51 | $10.00 | $10.72 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $3.47 Median $3.98 Typical High $4.27 | Professional | 53 · Discontinued | $3.47 | $3.98 | $4.27 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $2.57 Median $3.02 Typical High $3.24 | Professional | 55 · Aftercare only | $2.57 | $3.02 | $3.24 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $1.74 Median $2.00 Typical High $2.14 | Professional | 56 · Pre-op care only | $1.74 | $2.00 | $2.14 |
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
$19.95
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.