How much rates vary
Facilitymedian $129 · 10th to 90th $83 to $407Professionalmedian $68 · 10th to 90th $24 to $117
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 $64.57 Median $77.62 Typical High $125.89 | Facility | None | $64.57 | $77.62 | $125.89 |
Aetna Setting Professional Modifier None (both parts) Typical Low $64.57 Median $77.62 Typical High $102.33 | Professional | None (both parts) | $64.57 | $77.62 | $102.33 |
Ambetter Setting Professional Modifier None (both parts) Typical Low $97.72 Median $97.72 Typical High $97.72 | Professional | None (both parts) | $97.72 | $97.72 | $97.72 |
BCBS Texas Setting Facility Modifier None Typical Low $93.33 Median $239.88 Typical High $467.74 | Facility | None | $93.33 | $239.88 | $467.74 |
BCBS Texas Setting Professional Modifier None (both parts) Typical Low $61.66 Median $69.18 Typical High $69.18 | Professional | None (both parts) | $61.66 | $69.18 | $69.18 |
Baylor Scott & White Setting Professional Modifier None (both parts) Typical Low $87.10 Median $100.00 Typical High $100.00 | Professional | None (both parts) | $87.10 | $100.00 | $100.00 |
Christus Setting Facility Modifier None Typical Low $83.18 Median $83.18 Typical High $83.18 | Facility | None | $83.18 | $83.18 | $83.18 |
Cigna Setting Facility Modifier None Typical Low $81.28 Median $81.28 Typical High $123.03 | Facility | None | $81.28 | $81.28 | $123.03 |
Cigna Setting Professional Modifier None (both parts) Typical Low $63.10 Median $85.11 Typical High $117.49 | Professional | None (both parts) | $63.10 | $85.11 | $117.49 |
Lucent Health Setting Professional Modifier None (both parts) Typical Low $537.03 Median $537.03 Typical High $707.95 | Professional | None (both parts) | $537.03 | $537.03 | $707.95 |
Moda Health Setting Facility Modifier None Typical Low $69.18 Median $87.10 Typical High $204.17 | Facility | None | $69.18 | $87.10 | $204.17 |
Moda Health Setting Professional Modifier None (both parts) Typical Low $64.57 Median $74.13 Typical High $89.13 | Professional | None (both parts) | $64.57 | $74.13 | $89.13 |
Molina Setting Professional Modifier None (both parts) Typical Low $10.72 Median $57.54 Typical High $70.79 | Professional | None (both parts) | $10.72 | $57.54 | $70.79 |
Oscar Health Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $67.61 | Facility | None | $67.61 | $67.61 | $67.61 |
Providence Setting Facility Modifier None Typical Low $77.62 Median $100.00 Typical High $134.90 | Facility | None | $77.62 | $100.00 | $134.90 |
Providence Setting Professional Modifier None (both parts) Typical Low $66.07 Median $85.11 Typical High $117.49 | Professional | None (both parts) | $66.07 | $85.11 | $117.49 |
United Setting Facility Modifier None Typical Low $67.61 Median $67.61 Typical High $93.33 | Facility | None | $67.61 | $67.61 | $93.33 |
United Setting Professional Modifier None (both parts) Typical Low $43.65 Median $74.13 Typical High $109.65 | Professional | None (both parts) | $43.65 | $74.13 | $109.65 |
Wellpoint Setting Professional Modifier None (both parts) Typical Low $85.11 Median $85.11 Typical High $85.11 | Professional | None (both parts) | $85.11 | $85.11 | $85.11 |
11 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 $32.36 Median $38.90 Typical High $46.77 | Professional | 52 · Reduced service | $32.36 | $38.90 | $46.77 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $15.49 Typical High $19.05 | Professional | 53 · Discontinued | $13.18 | $15.49 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.75 Typical High $14.13 | Professional | 55 · Aftercare only | $9.77 | $11.75 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.76 Typical High $9.33 | Professional | 56 · Pre-op care only | $6.46 | $7.76 | $9.33 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $45.71 Median $66.07 Typical High $66.07 | Professional | GN · Speech therapy plan | $45.71 | $66.07 | $66.07 |
Christus Setting Professional Modifier 26 · Professional part Typical Low $83.18 Median $83.18 Typical High $83.18 | Professional | 26 · Professional part | $83.18 | $83.18 | $83.18 |
Moda Health Setting Facility Modifier GN · Speech therapy plan Typical Low $85.11 Median $229.09 Typical High $389.05 | Facility | GN · Speech therapy plan | $85.11 | $229.09 | $389.05 |
Moda Health Setting Professional Modifier 52 · Reduced service Typical Low $32.36 Median $38.90 Typical High $46.77 | Professional | 52 · Reduced service | $32.36 | $38.90 | $46.77 |
Moda Health Setting Professional Modifier 53 · Discontinued Typical Low $13.18 Median $15.49 Typical High $19.05 | Professional | 53 · Discontinued | $13.18 | $15.49 | $19.05 |
Moda Health Setting Professional Modifier 55 · Aftercare only Typical Low $9.77 Median $11.75 Typical High $14.13 | Professional | 55 · Aftercare only | $9.77 | $11.75 | $14.13 |
Moda Health Setting Professional Modifier 56 · Pre-op care only Typical Low $6.46 Median $7.76 Typical High $9.55 | Professional | 56 · Pre-op care only | $6.46 | $7.76 | $9.55 |
Where Texas sits
The same service costs 2.9 times more in Alaska than in Utah. 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· 47th of 51
$67.61
AK $186UT $64.57
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.