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 $575,439.94 Median $676,082.98 Typical High $724,435.96 | Professional | None | $575,439.94 | $676,082.98 | $724,435.96 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $575,439.94 Median $724,435.96 Typical High $724,435.96 | Facility | None | $575,439.94 | $724,435.96 | $724,435.96 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $724,435.96 Median $724,435.96 Typical High $776,247.12 | Professional | None | $724,435.96 | $724,435.96 | $776,247.12 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $630,957.34 Typical High $645,654.23 | Professional | None | $79.43 | $630,957.34 | $645,654.23 |
United Setting Professional Modifier None Typical Low $562,341.33 Median $562,341.33 Typical High $562,341.33 | Professional | None | $562,341.33 | $562,341.33 | $562,341.33 |
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 $288,403.15 Median $338,844.16 Typical High $363,078.05 | Professional | 52 · Reduced service | $288,403.15 | $338,844.16 | $363,078.05 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $114,815.36 Median $134,896.29 Typical High $144,543.98 | Professional | 53 · Discontinued | $114,815.36 | $134,896.29 | $144,543.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $87,096.36 Median $100,000.00 Typical High $109,647.82 | Professional | 55 · Aftercare only | $87,096.36 | $100,000.00 | $109,647.82 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $57,543.99 Median $67,608.30 Typical High $72,443.60 | Professional | 56 · Pre-op care only | $57,543.99 | $67,608.30 | $72,443.60 |
Where Montana sits
The same service costs 1.7 times more in Texas than in Minnesota. 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· 11th of 51
$630,957
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.