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 $5.25 Median $5.37 Typical High $6.61 | Professional | None | $5.25 | $5.37 | $6.61 |
BCBS Montana Setting Facility Modifier None Typical Low $16.98 Median $16.98 Typical High $16.98 | Facility | None | $16.98 | $16.98 | $16.98 |
Cigna Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Facility | None | $8.51 | $8.51 | $10.00 |
Cigna Setting Professional Modifier None Typical Low $5.25 Median $8.51 Typical High $8.51 | Professional | None | $5.25 | $8.51 | $8.51 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $5.01 Median $6.31 Typical High $7.08 | Facility | None | $5.01 | $6.31 | $7.08 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $5.01 Median $6.61 Typical High $7.08 | Professional | None | $5.01 | $6.61 | $7.08 |
Providence Setting Facility Modifier None Typical Low $8.51 Median $8.51 Typical High $10.00 | Facility | None | $8.51 | $8.51 | $10.00 |
Providence Setting Professional Modifier None Typical Low $6.76 Median $8.32 Typical High $8.51 | Professional | None | $6.76 | $8.32 | $8.51 |
United Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
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 $2.63 Median $3.09 Typical High $3.31 | Professional | 52 · Reduced service | $2.63 | $3.09 | $3.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $1.07 Median $1.23 Typical High $1.32 | Professional | 53 · Discontinued | $1.07 | $1.23 | $1.32 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.79 Median $0.91 Typical High $1.00 | Professional | 55 · Aftercare only | $0.79 | $0.91 | $1.00 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $0.52 Median $0.62 Typical High $0.66 | Professional | 56 · Pre-op care only | $0.52 | $0.62 | $0.66 |
Where Montana sits
The same service costs 1.9 times more in Wyoming than in Colorado. 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
$6.76
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.