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 $4.27 Median $4.68 Typical High $5.37 | Professional | None | $4.27 | $4.68 | $5.37 |
BCBS Montana Setting Facility Modifier None Typical Low $18.62 Median $21.88 Typical High $35.48 | Facility | None | $18.62 | $21.88 | $35.48 |
Cigna Setting Facility Modifier None Typical Low $6.76 Median $8.13 Typical High $10.00 | Facility | None | $6.76 | $8.13 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $8.13 Typical High $8.13 | Professional | None | $4.27 | $8.13 | $8.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $4.27 Median $5.37 Typical High $9.12 | Facility | None | $4.27 | $5.37 | $9.12 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5.01 Median $5.75 Typical High $6.31 | Professional | None | $5.01 | $5.75 | $6.31 |
Providence Setting Facility Modifier None Typical Low $6.76 Median $8.13 Typical High $10.00 | Facility | None | $6.76 | $8.13 | $10.00 |
Providence Setting Professional Modifier None Typical Low $5.50 Median $8.13 Typical High $8.13 | Professional | None | $5.50 | $8.13 | $8.13 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.01 Typical High $5.01 | Professional | None | $5.01 | $5.01 | $5.01 |
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 $2.14 Median $2.51 Typical High $2.69 | Professional | 52 · Reduced service | $2.14 | $2.51 | $2.69 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.85 Median $1.00 Typical High $1.07 | Professional | 53 · Discontinued | $0.85 | $1.00 | $1.07 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.65 Median $0.76 Typical High $0.79 | Professional | 55 · Aftercare only | $0.65 | $0.76 | $0.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.43 Median $0.50 Typical High $0.54 | Professional | 56 · Pre-op care only | $0.43 | $0.50 | $0.54 |
Where Montana sits
The same service costs 5.1 times more in Wyoming than in Alabama. 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· 5th of 51
$5.50
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.