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 $36.31 Median $36.31 Typical High $72.44 | Professional | None | $36.31 | $36.31 | $72.44 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $18.20 Median $18.20 Typical High $36.31 | Professional | 52 · Reduced service | $18.20 | $18.20 | $36.31 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $7.24 Median $7.24 Typical High $14.45 | Professional | 53 · Discontinued | $7.24 | $7.24 | $14.45 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.37 Median $5.37 Typical High $10.96 | Professional | 55 · Aftercare only | $5.37 | $5.37 | $10.96 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.63 Median $3.63 Typical High $7.24 | Professional | 56 · Pre-op care only | $3.63 | $3.63 | $7.24 |
Cigna Setting Professional Modifier None Typical Low $1,071.52 Median $1,071.52 Typical High $1,071.52 | Professional | None | $1,071.52 | $1,071.52 | $1,071.52 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $85.11 | Professional | None | $79.43 | $79.43 | $85.11 |
1 more rate 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 |
|---|---|---|---|---|---|
MountainHealth Co-op Setting Facility Modifier CSTM-00 Typical Low $194.98 Median $194.98 Typical High $316.23 | Facility | CSTM-00 | $194.98 | $194.98 | $316.23 |
Where Montana sits
The same service costs 35.5 times more in Texas than in Kentucky. 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· 29th of 51
$79.43
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.