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 $31.62 Median $32.36 Typical High $39.81 | Professional | None | $31.62 | $32.36 | $39.81 |
BCBS Montana Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $229.09 | Facility | None | $50.12 | $50.12 | $229.09 |
Cigna Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Cigna Setting Professional Modifier None Typical Low $31.62 Median $53.70 Typical High $53.70 | Professional | None | $31.62 | $53.70 | $53.70 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $31.62 Median $39.81 Typical High $44.67 | Facility | None | $31.62 | $39.81 | $44.67 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $35.48 Median $39.81 Typical High $44.67 | Professional | None | $35.48 | $39.81 | $44.67 |
Providence Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $53.70 | Facility | None | $53.70 | $53.70 | $53.70 |
Providence Setting Professional Modifier None Typical Low $34.67 Median $53.70 Typical High $79.43 | Professional | None | $34.67 | $53.70 | $79.43 |
United Setting Professional Modifier None Typical Low $35.48 Median $35.48 Typical High $35.48 | Professional | None | $35.48 | $35.48 | $35.48 |
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 $15.85 Median $18.62 Typical High $19.95 | Professional | 52 · Reduced service | $15.85 | $18.62 | $19.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.46 Median $7.41 Typical High $7.94 | Professional | 53 · Discontinued | $6.46 | $7.41 | $7.94 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $4.79 Median $5.62 Typical High $6.03 | Professional | 55 · Aftercare only | $4.79 | $5.62 | $6.03 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.24 Median $3.72 Typical High $3.98 | Professional | 56 · Pre-op care only | $3.24 | $3.72 | $3.98 |
Where Montana sits
The same service costs 1.7 times more in Hawaii 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· 9th of 51
$39.81
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.