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 $25.70 Median $28.84 Typical High $32.36 | Professional | None | $25.70 | $28.84 | $32.36 |
BCBS Montana Setting Facility Modifier None Typical Low $42.66 Median $42.66 Typical High $162.18 | Facility | None | $42.66 | $42.66 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $30.90 Typical High $30.90 | Professional | None | $25.70 | $30.90 | $30.90 |
MountainHealth Co-op Setting Facility Modifier None Typical Low $25.70 Median $32.36 Typical High $34.67 | Facility | None | $25.70 | $32.36 | $34.67 |
MountainHealth Co-op Setting Professional Modifier None Typical Low $25.70 Median $32.36 Typical High $34.67 | Professional | None | $25.70 | $32.36 | $34.67 |
Providence Setting Facility Modifier None Typical Low $30.90 Median $30.90 Typical High $30.90 | Facility | None | $30.90 | $30.90 | $30.90 |
Providence Setting Professional Modifier None Typical Low $28.18 Median $30.90 Typical High $79.43 | Professional | None | $28.18 | $30.90 | $79.43 |
United Setting Professional Modifier None Typical Low $25.70 Median $25.70 Typical High $25.70 | Professional | None | $25.70 | $25.70 | $25.70 |
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 $12.88 Median $15.14 Typical High $16.22 | Professional | 52 · Reduced service | $12.88 | $15.14 | $16.22 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $5.13 Median $6.03 Typical High $6.46 | Professional | 53 · Discontinued | $5.13 | $6.03 | $6.46 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $3.89 Median $4.47 Typical High $4.79 | Professional | 55 · Aftercare only | $3.89 | $4.47 | $4.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $2.57 Median $3.02 Typical High $3.24 | Professional | 56 · Pre-op care only | $2.57 | $3.02 | $3.24 |
Where Montana sits
Rates are fairly even across states for this service. 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· 4th of 51
$30.90
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.