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 $426.58 Median $446.68 Typical High $912.01 | Professional | None | $426.58 | $446.68 | $912.01 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | None | $79.43 | $79.43 | $79.43 |
United Setting Professional Modifier None Typical Low $199.53 Median $223.87 Typical High $371.54 | Professional | None | $199.53 | $223.87 | $371.54 |
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 $213.80 Median $218.78 Typical High $457.09 | Professional | 52 · Reduced service | $213.80 | $218.78 | $457.09 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $85.11 Median $89.13 Typical High $181.97 | Professional | 53 · Discontinued | $85.11 | $89.13 | $181.97 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $64.57 Median $66.07 Typical High $134.90 | Professional | 55 · Aftercare only | $64.57 | $66.07 | $134.90 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $42.66 Median $44.67 Typical High $91.20 | Professional | 56 · Pre-op care only | $42.66 | $44.67 | $91.20 |
Where Montana sits
The same service costs 38.0 times more in Minnesota than in Connecticut. 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· 40th of 51
$224
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.