How much rates vary
Facilitymedian $102 · 10th to 90th $51 to $1,445Professionalmedian $78 · 10th to 90th $29 to $151
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 Facility Modifier None Typical Low $38.02 Median $69.18 Typical High $87.10 | Facility | None | $38.02 | $69.18 | $87.10 |
Aetna Setting Professional Modifier None Typical Low $33.88 Median $69.18 Typical High $91.20 | Professional | None | $33.88 | $69.18 | $91.20 |
Ambetter Setting Professional Modifier None Typical Low $34.67 Median $75.86 Typical High $93.33 | Professional | None | $34.67 | $75.86 | $93.33 |
BCBS Texas Setting Facility Modifier None Typical Low $50.12 Median $74.13 Typical High $512.86 | Facility | None | $50.12 | $74.13 | $512.86 |
BCBS Texas Setting Professional Modifier None Typical Low $37.15 Median $69.18 Typical High $109.65 | Professional | None | $37.15 | $69.18 | $109.65 |
Christus Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
Cigna Setting Facility Modifier None Typical Low $60.26 Median $81.28 Typical High $128.82 | Facility | None | $60.26 | $81.28 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $112.20 | Professional | None | $44.67 | $79.43 | $112.20 |
Lucent Health Setting Professional Modifier None Typical Low $616.60 Median $616.60 Typical High $851.14 | Professional | None | $616.60 | $616.60 | $851.14 |
Moda Health Setting Facility Modifier None Typical Low $40.74 Median $302.00 Typical High $602.56 | Facility | None | $40.74 | $302.00 | $602.56 |
Moda Health Setting Professional Modifier None Typical Low $33.88 Median $69.18 Typical High $104.71 | Professional | None | $33.88 | $69.18 | $104.71 |
Molina Setting Professional Modifier None Typical Low $14.79 Median $83.18 Typical High $109.65 | Professional | None | $14.79 | $83.18 | $109.65 |
Oscar Health Setting Professional Modifier None Typical Low $134.90 Median $147.91 Typical High $363.08 | Professional | None | $134.90 | $147.91 | $363.08 |
Providence Setting Facility Modifier None Typical Low $50.12 Median $83.18 Typical High $128.82 | Facility | None | $50.12 | $83.18 | $128.82 |
Providence Setting Professional Modifier None Typical Low $44.67 Median $79.43 Typical High $112.20 | Professional | None | $44.67 | $79.43 | $112.20 |
United Setting Facility Modifier None Typical Low $141.25 Median $741.31 Typical High $2,187.76 | Facility | None | $141.25 | $741.31 | $2,187.76 |
United Setting Professional Modifier None Typical Low $38.90 Median $69.18 Typical High $109.65 | Professional | None | $38.90 | $69.18 | $109.65 |
Wellpoint Setting Professional Modifier None Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None | $97.72 | $97.72 | $97.72 |
9 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 $16.98 Median $33.88 Typical High $42.66 | Professional | 52 · Reduced service | $16.98 | $33.88 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $13.80 Typical High $17.38 | Professional | 53 · Discontinued | $6.76 | $13.80 | $17.38 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $10.23 Typical High $12.88 | Professional | 55 · Aftercare only | $5.13 | $10.23 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $3.39 Median $6.92 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.39 | $6.92 | $8.71 |
Moda Health Setting Facility Modifier GO · Occupational therapy plan Typical Low $229.09 Median $295.12 Typical High $295.12 | Facility | GO · Occupational therapy plan | $229.09 | $295.12 | $295.12 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $16.98 Median $33.88 Typical High $41.69 | Professional | 52 · Reduced service | $16.98 | $33.88 | $41.69 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $6.76 Median $13.80 Typical High $16.98 | Professional | 53 · Discontinued | $6.76 | $13.80 | $16.98 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $5.13 Median $10.23 Typical High $12.59 | Professional | 55 · Aftercare only | $5.13 | $10.23 | $12.59 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $3.80 Median $6.92 Typical High $8.71 | Professional | 56 · Pre-op care only | $3.80 | $6.92 | $8.71 |
Where Texas sits
The same service costs 3.8 times more in Alaska than in Virginia. 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.
Texas· 40th of 51
$77.62
AK $214VA $56.23
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.