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 $57.54 Median $61.66 Typical High $61.66 | Professional | None | $57.54 | $61.66 | $61.66 |
Cigna Setting Facility Modifier None Typical Low $89.13 Median $123.03 Typical High $380.19 | Facility | None | $89.13 | $123.03 | $380.19 |
Cigna Setting Professional Modifier None Typical Low $61.66 Median $89.13 Typical High $89.13 | Professional | None | $61.66 | $89.13 | $89.13 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $57.54 Median $93.33 Typical High $107.15 | Facility | None | $57.54 | $93.33 | $107.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $57.54 Median $70.79 Typical High $104.71 | Professional | None | $57.54 | $70.79 | $104.71 |
Providence Setting Facility Modifier None Typical Low $89.13 Median $123.03 Typical High $380.19 | Facility | None | $89.13 | $123.03 | $380.19 |
Providence Setting Professional Modifier None Typical Low $60.26 Median $81.28 Typical High $91.20 | Professional | None | $60.26 | $81.28 | $91.20 |
United Setting Professional Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Professional | None | $60.26 | $60.26 | $60.26 |
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 $28.84 Median $30.90 Typical High $30.90 | Professional | 52 · Reduced service | $28.84 | $30.90 | $30.90 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.48 Median $12.30 Typical High $12.59 | Professional | 53 · Discontinued | $11.48 | $12.30 | $12.59 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.71 Median $9.33 Typical High $9.33 | Professional | 55 · Aftercare only | $8.71 | $9.33 | $9.33 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.75 Median $6.17 Typical High $6.17 | Professional | 56 · Pre-op care only | $5.75 | $6.17 | $6.17 |
Where Montana sits
The same service costs 1.6 times more in Alaska 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· 4th 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.