How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $87.10 Median $87.10 Typical High $229.09 | Facility | None | $87.10 | $87.10 | $229.09 |
Aetna Setting Professional Modifier None Typical Low $77.62 Median $87.10 Typical High $100.00 | Professional | None | $77.62 | $87.10 | $100.00 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $38.90 Median $43.65 Typical High $45.71 | Professional | 52 · Reduced service | $38.90 | $43.65 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.49 Median $17.38 Typical High $18.20 | Professional | 53 · Discontinued | $15.49 | $17.38 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $13.18 Typical High $13.49 | Professional | 55 · Aftercare only | $11.75 | $13.18 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $8.71 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.76 | $8.71 | $9.12 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $141.25 Typical High $141.25 | Facility | None | $141.25 | $141.25 | $141.25 |
Cigna Setting Professional Modifier None Typical Low $26.92 Median $79.43 Typical High $104.71 | Professional | None | $26.92 | $79.43 | $104.71 |
United Setting Professional Modifier None Typical Low $32.36 Median $72.44 Typical High $131.83 | Professional | None | $32.36 | $72.44 | $131.83 |
2 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier GN · Speech therapy plan Typical Low $79.43 Median $218.78 Typical High $331.13 | Facility | GN · Speech therapy plan | $79.43 | $218.78 | $331.13 |
Highmark BCBS Setting Professional Modifier GN · Speech therapy plan + GO · Occupational therapy plan Typical Low $81.28 Median $81.28 Typical High $81.28 | Professional | GN · Speech therapy plan + GO · Occupational therapy plan | $81.28 | $81.28 | $81.28 |
Where Delaware 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.
Delaware· 31st of 51
$87.10
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.