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 $32.36 Median $35.48 Typical High $40.74 | Professional | None | $32.36 | $35.48 | $40.74 |
BCBS Montana Setting Facility Modifier None Typical Low $32.36 Median $33.11 Typical High $63.10 | Facility | None | $32.36 | $33.11 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Cigna Setting Professional Modifier None Typical Low $32.36 Median $39.81 Typical High $39.81 | Professional | None | $32.36 | $39.81 | $39.81 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $32.36 Median $40.74 Typical High $44.67 | Facility | None | $32.36 | $40.74 | $44.67 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $32.36 Median $40.74 Typical High $43.65 | Professional | None | $32.36 | $40.74 | $43.65 |
Providence Setting Facility Modifier None Typical Low $39.81 Median $39.81 Typical High $39.81 | Facility | None | $39.81 | $39.81 | $39.81 |
Providence Setting Professional Modifier None Typical Low $39.81 Median $41.69 Typical High $79.43 | Professional | None | $39.81 | $41.69 | $79.43 |
United Setting Professional Modifier None Typical Low $32.36 Median $32.36 Typical High $32.36 | Professional | None | $32.36 | $32.36 | $32.36 |
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 $16.22 Median $19.05 Typical High $20.42 | Professional | 52 · Reduced service | $16.22 | $19.05 | $20.42 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.59 Typical High $8.13 | Professional | 53 · Discontinued | $6.46 | $7.59 | $8.13 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.90 Median $5.62 Typical High $6.17 | Professional | 55 · Aftercare only | $4.90 | $5.62 | $6.17 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.80 Typical High $4.07 | Professional | 56 · Pre-op care only | $3.24 | $3.80 | $4.07 |
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
$39.81
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.