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 $69.18 Median $114.82 Typical High $114.82 | Professional | None | $69.18 | $114.82 | $114.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $34.67 Median $57.54 Typical High $57.54 | Professional | 52 · Reduced service | $34.67 | $57.54 | $57.54 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $22.91 Typical High $22.91 | Professional | 53 · Discontinued | $13.80 | $22.91 | $22.91 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $17.38 Typical High $17.38 | Professional | 55 · Aftercare only | $10.47 | $17.38 | $17.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $11.48 Typical High $11.48 | Professional | 56 · Pre-op care only | $6.92 | $11.48 | $11.48 |
Cigna Setting Professional Modifier None Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | None | $165.96 | $165.96 | $165.96 |
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 $165.96 Median $165.96 Typical High $269.15 | Facility | CSTM-00 | $165.96 | $165.96 | $269.15 |
Where Montana sits
The same service costs 6.8 times more in North Carolina 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· 37th 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.