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 $20.89 Median $22.91 Typical High $26.30 | Professional | None | $20.89 | $22.91 | $26.30 |
BCBS Montana Setting Facility Modifier None Typical Low $173.78 Median $204.17 Typical High $223.87 | Facility | None | $173.78 | $204.17 | $223.87 |
Cigna Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $33.11 Typical High $33.11 | Professional | None | $20.89 | $33.11 | $33.11 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $20.89 Median $28.18 Typical High $37.15 | Facility | None | $20.89 | $28.18 | $37.15 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $26.30 Median $29.51 Typical High $37.15 | Professional | None | $26.30 | $29.51 | $37.15 |
Providence Setting Facility Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Facility | None | $33.11 | $33.11 | $33.11 |
Providence Setting Professional Modifier None Typical Low $22.91 Median $33.11 Typical High $79.43 | Professional | None | $22.91 | $33.11 | $79.43 |
United Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $29.51 | Professional | None | $29.51 | $29.51 | $29.51 |
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 $10.47 Median $12.30 Typical High $13.18 | Professional | 52 · Reduced service | $10.47 | $12.30 | $13.18 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $4.17 Median $4.90 Typical High $5.25 | Professional | 53 · Discontinued | $4.17 | $4.90 | $5.25 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.16 Median $3.63 Typical High $3.98 | Professional | 55 · Aftercare only | $3.16 | $3.63 | $3.98 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.09 Median $2.45 Typical High $2.63 | Professional | 56 · Pre-op care only | $2.09 | $2.45 | $2.63 |
Where Montana sits
The same service costs 3.8 times more in Wyoming than in Kentucky. 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
$29.51
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.