How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $21.38 Median $22.39 Typical High $22.91 | Professional | None | $21.38 | $22.39 | $22.91 |
Cigna Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Cigna Setting Professional Modifier None Typical Low $22.39 Median $22.39 Typical High $25.12 | Professional | None | $22.39 | $22.39 | $25.12 |
Providence Setting Facility Modifier None Typical Low $28.84 Median $28.84 Typical High $28.84 | Facility | None | $28.84 | $28.84 | $28.84 |
Providence Setting Professional Modifier None Typical Low $21.88 Median $33.11 Typical High $79.43 | Professional | None | $21.88 | $33.11 | $79.43 |
United Setting Professional Modifier None Typical Low $21.88 Median $21.88 Typical High $21.88 | Professional | None | $21.88 | $21.88 | $21.88 |
5 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 $10.47 Median $11.22 Typical High $11.48 | Professional | 52 · Reduced service | $10.47 | $11.22 | $11.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.27 Median $4.47 Typical High $4.57 | Professional | 53 · Discontinued | $4.27 | $4.47 | $4.57 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.39 Typical High $3.39 | Professional | 55 · Aftercare only | $3.16 | $3.39 | $3.39 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.14 Median $2.24 Typical High $2.29 | Professional | 56 · Pre-op care only | $2.14 | $2.24 | $2.29 |
MountainHealth Co-op Setting Facility Modifier 78 · Unplanned return to OR Typical Low $26.92 Median $26.92 Typical High $26.92 | Facility | 78 · Unplanned return to OR | $26.92 | $26.92 | $26.92 |
Where Montana sits
The same service costs 1.5 times more in Alaska than in Arizona. 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
$27.54
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.