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 $30.90 Median $35.48 Typical High $38.02 | Professional | None | $30.90 | $35.48 | $38.02 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Cigna Setting Professional Modifier None Typical Low $30.90 Median $38.90 Typical High $38.90 | Professional | None | $30.90 | $38.90 | $38.90 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $30.90 Median $38.02 Typical High $41.69 | Facility | None | $30.90 | $38.02 | $41.69 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $30.90 Median $38.02 Typical High $41.69 | Professional | None | $30.90 | $38.02 | $41.69 |
Providence Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $38.90 | Facility | None | $38.90 | $38.90 | $38.90 |
Providence Setting Professional Modifier None Typical Low $38.02 Median $38.90 Typical High $79.43 | Professional | None | $38.02 | $38.90 | $79.43 |
United Setting Professional Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Professional | None | $30.90 | $30.90 | $30.90 |
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 $15.49 Median $17.78 Typical High $19.05 | Professional | 52 · Reduced service | $15.49 | $17.78 | $19.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $7.08 Typical High $7.76 | Professional | 53 · Discontinued | $6.17 | $7.08 | $7.76 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.57 Median $5.37 Typical High $5.75 | Professional | 55 · Aftercare only | $4.57 | $5.37 | $5.75 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $3.55 Typical High $3.80 | Professional | 56 · Pre-op care only | $3.09 | $3.55 | $3.80 |
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
$38.90
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.