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 $407.38 Median $446.68 Typical High $512.86 | Professional | None | $407.38 | $446.68 | $512.86 |
BCBS Montana Setting Facility Modifier None Typical Low $588.84 Median $691.83 Typical High $758.58 | Facility | None | $588.84 | $691.83 | $758.58 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $389.05 Median $489.78 Typical High $630.96 | Facility | None | $389.05 | $489.78 | $630.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $389.05 Median $512.86 Typical High $549.54 | Professional | None | $389.05 | $512.86 | $549.54 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $457.09 Typical High $524.81 | Professional | None | $79.43 | $457.09 | $524.81 |
United Setting Professional Modifier None Typical Low $389.05 Median $389.05 Typical High $389.05 | Professional | None | $389.05 | $389.05 | $389.05 |
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 $204.17 Median $239.88 Typical High $257.04 | Professional | 52 · Reduced service | $204.17 | $239.88 | $257.04 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $81.28 Median $95.50 Typical High $102.33 | Professional | 53 · Discontinued | $81.28 | $95.50 | $102.33 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $61.66 Median $70.79 Typical High $77.62 | Professional | 55 · Aftercare only | $61.66 | $70.79 | $77.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $40.74 Median $47.86 Typical High $51.29 | Professional | 56 · Pre-op care only | $40.74 | $47.86 | $51.29 |
Where Montana sits
The same service costs 1.5 times more in Alaska than in Oklahoma. 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· 7th of 51
$437
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.