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 $79.43 Median $79.43 Typical High $120.23 | Facility | None | $79.43 | $79.43 | $120.23 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $100.00 | Professional | None | $79.43 | $79.43 | $100.00 |
Anthem BCBS Setting Professional Modifier None Typical Low $63.10 Median $89.13 Typical High $134.90 | Professional | None | $63.10 | $89.13 | $134.90 |
CareSource Setting Professional Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | None | $109.65 | $109.65 | $109.65 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $93.33 Typical High $190.55 | Professional | None | $54.95 | $93.33 | $190.55 |
Kaiser Permanente Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $181.97 | Professional | None | $75.86 | $93.33 | $181.97 |
Oscar Health Setting Facility Modifier None Typical Low $141.25 Median $165.96 Typical High $251.19 | Facility | None | $141.25 | $165.96 | $251.19 |
United Setting Professional Modifier None Typical Low $40.74 Median $91.20 Typical High $208.93 | Professional | None | $40.74 | $91.20 | $208.93 |
5 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 $38.90 Median $38.90 Typical High $44.67 | Professional | 52 · Reduced service | $38.90 | $38.90 | $44.67 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $15.85 Typical High $17.78 | Professional | 53 · Discontinued | $15.85 | $15.85 | $17.78 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $11.75 Median $11.75 Typical High $13.49 | Professional | 55 · Aftercare only | $11.75 | $11.75 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.76 Median $7.76 Typical High $8.91 | Professional | 56 · Pre-op care only | $7.76 | $7.76 | $8.91 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $67.61 Median $70.79 Typical High $79.43 | Professional | GN · Speech therapy plan | $67.61 | $70.79 | $79.43 |
Where Georgia 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.
Georgia· 28th of 51
$89.13
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.