How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $457.09 Median $489.78 Typical High $489.78 | Professional | None | $457.09 | $489.78 | $489.78 |
BCBS Montana Setting Facility Modifier None Typical Low $676.08 Median $794.33 Typical High $912.01 | Facility | None | $676.08 | $794.33 | $912.01 |
Cigna Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $2,754.23 | Facility | None | $724.44 | $954.99 | $2,754.23 |
Cigna Setting Professional Modifier None Typical Low $512.86 Median $512.86 Typical High $549.54 | Professional | None | $512.86 | $512.86 | $549.54 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $501.19 Median $501.19 Typical High $1,174.90 | Facility | None | $501.19 | $501.19 | $1,174.90 |
Providence Setting Facility Modifier None Typical Low $724.44 Median $954.99 Typical High $2,754.23 | Facility | None | $724.44 | $954.99 | $2,754.23 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $512.86 | Professional | None | $79.43 | $79.43 | $512.86 |
United Setting Professional Modifier None Typical Low $575.44 Median $575.44 Typical High $575.44 | Professional | None | $575.44 | $575.44 | $575.44 |
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 $229.09 Median $245.47 Typical High $245.47 | Professional | 52 · Reduced service | $229.09 | $245.47 | $245.47 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $91.20 Median $97.72 Typical High $100.00 | Professional | 53 · Discontinued | $91.20 | $97.72 | $100.00 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $69.18 Median $74.13 Typical High $74.13 | Professional | 55 · Aftercare only | $69.18 | $74.13 | $74.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $45.71 Median $48.98 Typical High $48.98 | Professional | 56 · Pre-op care only | $45.71 | $48.98 | $48.98 |
Where Montana sits
The same service costs 1.6 times more in Alaska than in Idaho. 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· 27th of 51
$513
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.