How much rates vary
Facilitymedian $170 · 10th to 90th $55 to $661Professionalmedian $89 · 10th to 90th $50 to $158
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 $91.20 Median $120.23 Typical High $338.84 | Facility | None | $91.20 | $120.23 | $338.84 |
Aetna Setting Professional Modifier None Typical Low $89.13 Median $100.00 Typical High $141.25 | Professional | None | $89.13 | $100.00 | $141.25 |
Anthem BCBS Setting Facility Modifier None Typical Low $52.48 Median $66.07 Typical High $275.42 | Facility | None | $52.48 | $66.07 | $275.42 |
Anthem BCBS Setting Professional Modifier None Typical Low $53.70 Median $79.43 Typical High $131.83 | Professional | None | $53.70 | $79.43 | $131.83 |
Blue Shield Setting Facility Modifier None Typical Low $112.20 Median $436.52 Typical High $776.25 | Facility | None | $112.20 | $436.52 | $776.25 |
Blue Shield Setting Professional Modifier None Typical Low $37.15 Median $64.57 Typical High $107.15 | Professional | None | $37.15 | $64.57 | $107.15 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $51.29 Median $95.50 Typical High $117.49 | Professional | None | $51.29 | $95.50 | $117.49 |
Cigna Setting Facility Modifier None Typical Low $93.33 Median $93.33 Typical High $93.33 | Facility | None | $93.33 | $93.33 | $93.33 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $89.13 Typical High $144.54 | Professional | None | $28.18 | $89.13 | $144.54 |
Contra Costa Health Setting Professional Modifier None Typical Low $33.88 Median $51.29 Typical High $125.89 | Professional | None | $33.88 | $51.29 | $125.89 |
Kaiser Permanente Setting Professional Modifier None Typical Low $69.18 Median $93.33 Typical High $162.18 | Professional | None | $69.18 | $93.33 | $162.18 |
Lucent Health Setting Professional Modifier None Typical Low $537.03 Median $707.95 Typical High $707.95 | Professional | None | $537.03 | $707.95 | $707.95 |
Molina Setting Professional Modifier None Typical Low $37.15 Median $46.77 Typical High $120.23 | Professional | None | $37.15 | $46.77 | $120.23 |
Optum Setting Professional Modifier None Typical Low $30.90 Median $54.95 Typical High $70.79 | Professional | None | $30.90 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $31.62 Median $112.20 Typical High $169.82 | Facility | None | $31.62 | $112.20 | $169.82 |
Providence Setting Professional Modifier None Typical Low $28.18 Median $89.13 Typical High $144.54 | Professional | None | $28.18 | $89.13 | $144.54 |
Sutter Health Plus Setting Professional Modifier None Typical Low $288.40 Median $288.40 Typical High $288.40 | Professional | None | $288.40 | $288.40 | $288.40 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $52.48 Median $79.43 Typical High $147.91 | Professional | None | $52.48 | $79.43 | $147.91 |
6 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 $42.66 Median $45.71 Typical High $52.48 | Professional | 52 · Reduced service | $42.66 | $45.71 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $18.20 Typical High $20.89 | Professional | 53 · Discontinued | $16.98 | $18.20 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.88 Median $13.80 Typical High $15.49 | Professional | 55 · Aftercare only | $12.88 | $13.80 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.51 Median $9.12 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.51 | $9.12 | $10.47 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $79.43 Median $79.43 Typical High $79.43 | Professional | GN · Speech therapy plan | $79.43 | $79.43 | $79.43 |
HealthNet Setting Professional Modifier GN · Speech therapy plan Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | GN · Speech therapy plan | $77.62 | $77.62 | $77.62 |
Where California 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.
California· 26th of 51
$91.20
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.