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 $0.12 Median $0.13 Typical High $0.13 | Professional | None | $0.12 | $0.13 | $0.13 |
BCBS Montana Setting Facility Modifier None Typical Low $1.51 Median $1.51 Typical High $1.51 | Facility | None | $1.51 | $1.51 | $1.51 |
Cigna Setting Facility Modifier None Typical Low $3.16 Median $4.37 Typical High $13.49 | Facility | None | $3.16 | $4.37 | $13.49 |
Cigna Setting Professional Modifier None Typical Low $0.13 Median $3.16 Typical High $3.16 | Professional | None | $0.13 | $3.16 | $3.16 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $2.00 Median $2.95 Typical High $3.72 | Facility | None | $2.00 | $2.95 | $3.72 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $2.00 Median $2.51 Typical High $3.63 | Professional | None | $2.00 | $2.51 | $3.63 |
Providence Setting Facility Modifier None Typical Low $3.16 Median $4.37 Typical High $13.49 | Facility | None | $3.16 | $4.37 | $13.49 |
Providence Setting Professional Modifier None Typical Low $1.95 Median $3.16 Typical High $79.43 | Professional | None | $1.95 | $3.16 | $79.43 |
United Setting Professional Modifier None Typical Low $0.13 Median $0.13 Typical High $0.13 | Professional | None | $0.13 | $0.13 | $0.13 |
3 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 $0.06 Median $0.07 Typical High $0.07 | Professional | 52 · Reduced service | $0.06 | $0.07 | $0.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $0.02 Median $0.03 Typical High $0.03 | Professional | 53 · Discontinued | $0.02 | $0.03 | $0.03 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $0.02 Median $0.02 Typical High $0.02 | Professional | 55 · Aftercare only | $0.02 | $0.02 | $0.02 |
Where Montana sits
The same service costs 32.4 times more in Montana than in Hawaii. 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· 1st of 51
$2.88
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.