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 $1,258.93 Median $1,445.44 Typical High $1,548.82 | Professional | None | $1,258.93 | $1,445.44 | $1,548.82 |
Cigna Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $4,168.69 | Facility | None | $1,778.28 | $1,778.28 | $4,168.69 |
Cigna Setting Professional Modifier None Typical Low $1,258.93 Median $1,778.28 Typical High $1,778.28 | Professional | None | $1,258.93 | $1,778.28 | $1,778.28 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $2,089.30 | Facility | None | $1,258.93 | $1,548.82 | $2,089.30 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $1,258.93 Median $1,548.82 Typical High $1,698.24 | Professional | None | $1,258.93 | $1,548.82 | $1,698.24 |
Providence Setting Facility Modifier None Typical Low $1,778.28 Median $1,778.28 Typical High $4,168.69 | Facility | None | $1,778.28 | $1,778.28 | $4,168.69 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $1,584.89 Typical High $1,778.28 | Professional | None | $79.43 | $1,584.89 | $1,778.28 |
United Setting Professional Modifier None Typical Low $1,258.93 Median $1,258.93 Typical High $1,258.93 | Professional | None | $1,258.93 | $1,258.93 | $1,258.93 |
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 $616.60 Median $724.44 Typical High $776.25 | Professional | 52 · Reduced service | $616.60 | $724.44 | $776.25 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $251.19 Median $288.40 Typical High $309.03 | Professional | 53 · Discontinued | $251.19 | $288.40 | $309.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $186.21 Median $218.78 Typical High $234.42 | Professional | 55 · Aftercare only | $186.21 | $218.78 | $234.42 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $125.89 Median $144.54 Typical High $154.88 | Professional | 56 · Pre-op care only | $125.89 | $144.54 | $154.88 |
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
$1,585
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.