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 $43.65 Median $43.65 Typical High $54.95 | Professional | None | $43.65 | $43.65 | $54.95 |
BCBS Montana Setting Facility Modifier None Typical Low $39.81 Median $46.77 Typical High $74.13 | Facility | None | $39.81 | $46.77 | $74.13 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $97.72 | Facility | None | $50.12 | $50.12 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $43.65 Median $50.12 Typical High $50.12 | Professional | None | $43.65 | $50.12 | $50.12 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $41.69 Median $52.48 Typical High $69.18 | Facility | None | $41.69 | $52.48 | $69.18 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $41.69 Median $54.95 Typical High $58.88 | Professional | None | $41.69 | $54.95 | $58.88 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $97.72 | Facility | None | $50.12 | $50.12 | $97.72 |
Providence Setting Professional Modifier None Typical Low $50.12 Median $54.95 Typical High $79.43 | Professional | None | $50.12 | $54.95 | $79.43 |
United Setting Professional Modifier None Typical Low $42.66 Median $42.66 Typical High $42.66 | Professional | None | $42.66 | $42.66 | $42.66 |
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 $21.88 Median $25.12 Typical High $27.54 | Professional | 52 · Reduced service | $21.88 | $25.12 | $27.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $8.71 Median $10.00 Typical High $10.96 | Professional | 53 · Discontinued | $8.71 | $10.00 | $10.96 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $6.61 Median $7.59 Typical High $8.13 | Professional | 55 · Aftercare only | $6.61 | $7.59 | $8.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $4.37 Median $5.01 Typical High $5.50 | Professional | 56 · Pre-op care only | $4.37 | $5.01 | $5.50 |
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
$50.12
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.