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 $30.90 Median $51.29 Typical High $58.88 | Professional | None | $30.90 | $51.29 | $58.88 |
Cigna Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $52.48 Median $97.72 Typical High $97.72 | Professional | None | $52.48 | $97.72 | $97.72 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $61.66 Median $104.71 Typical High $114.82 | Facility | None | $61.66 | $104.71 | $114.82 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $61.66 Median $77.62 Typical High $112.20 | Professional | None | $61.66 | $77.62 | $112.20 |
Providence Setting Facility Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Facility | None | $97.72 | $97.72 | $97.72 |
Providence Setting Professional Modifier None Typical Low $54.95 Median $83.18 Typical High $97.72 | Professional | None | $54.95 | $83.18 | $97.72 |
United Setting Professional Modifier None Typical Low $61.66 Median $61.66 Typical High $61.66 | Professional | None | $61.66 | $61.66 | $61.66 |
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 $15.49 Median $25.70 Typical High $29.51 | Professional | 52 · Reduced service | $15.49 | $25.70 | $29.51 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.17 Median $10.23 Typical High $11.75 | Professional | 53 · Discontinued | $6.17 | $10.23 | $11.75 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.68 Median $7.76 Typical High $8.91 | Professional | 55 · Aftercare only | $4.68 | $7.76 | $8.91 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.09 Median $5.13 Typical High $5.89 | Professional | 56 · Pre-op care only | $3.09 | $5.13 | $5.89 |
Where Montana sits
The same service costs 4.6 times more in New York than in North Carolina. 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· 5th 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.