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 $691.83 Median $794.33 Typical High $851.14 | Professional | None | $691.83 | $794.33 | $851.14 |
Cigna Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Cigna Setting Professional Modifier None Typical Low $691.83 Median $794.33 Typical High $794.33 | Professional | None | $691.83 | $794.33 | $794.33 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $691.83 Median $851.14 Typical High $933.25 | Facility | None | $691.83 | $851.14 | $933.25 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $691.83 Median $851.14 Typical High $933.25 | Professional | None | $691.83 | $851.14 | $933.25 |
Providence Setting Facility Modifier None Typical Low $794.33 Median $794.33 Typical High $794.33 | Facility | None | $794.33 | $794.33 | $794.33 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $794.33 Typical High $870.96 | Professional | None | $79.43 | $794.33 | $870.96 |
United Setting Professional Modifier None Typical Low $691.83 Median $691.83 Typical High $691.83 | Professional | None | $691.83 | $691.83 | $691.83 |
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 $338.84 Median $398.11 Typical High $426.58 | Professional | 52 · Reduced service | $338.84 | $398.11 | $426.58 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $138.04 Median $158.49 Typical High $169.82 | Professional | 53 · Discontinued | $138.04 | $158.49 | $169.82 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $102.33 Median $120.23 Typical High $128.82 | Professional | 55 · Aftercare only | $102.33 | $120.23 | $128.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $69.18 Median $79.43 Typical High $85.11 | Professional | 56 · Pre-op care only | $69.18 | $79.43 | $85.11 |
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· 3rd of 51
$794
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.