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 $70.79 Median $75.86 Typical High $91.20 | Professional | None | $70.79 | $75.86 | $91.20 |
BCBS Montana Setting Facility Modifier None Typical Low $87.10 Median $134.90 Typical High $257.04 | Facility | None | $87.10 | $134.90 | $257.04 |
Cigna Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $302.00 | Facility | None | $87.10 | $87.10 | $302.00 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $87.10 | Professional | None | $70.79 | $87.10 | $87.10 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $70.79 Median $87.10 Typical High $120.23 | Facility | None | $70.79 | $87.10 | $120.23 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $74.13 Median $87.10 Typical High $95.50 | Professional | None | $74.13 | $87.10 | $95.50 |
Providence Setting Facility Modifier None Typical Low $87.10 Median $87.10 Typical High $302.00 | Facility | None | $87.10 | $87.10 | $302.00 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $87.10 Typical High $91.20 | Professional | None | $79.43 | $87.10 | $91.20 |
United Setting Professional Modifier None Typical Low $74.13 Median $74.13 Typical High $74.13 | Professional | None | $74.13 | $74.13 | $74.13 |
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 $35.48 Median $40.74 Typical High $43.65 | Professional | 52 · Reduced service | $35.48 | $40.74 | $43.65 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.13 Median $16.22 Typical High $17.38 | Professional | 53 · Discontinued | $14.13 | $16.22 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $12.30 Typical High $13.18 | Professional | 55 · Aftercare only | $10.47 | $12.30 | $13.18 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.08 Median $8.13 Typical High $8.71 | Professional | 56 · Pre-op care only | $7.08 | $8.13 | $8.71 |
Where Montana sits
The same service costs 1.5 times more in Wyoming than in Florida. 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· 4th of 51
$87.10
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.