How much rates vary
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 $81.28 Median $83.18 Typical High $151.36 | Facility | None | $81.28 | $83.18 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $81.28 Median $83.18 Typical High $89.13 | Professional | None | $81.28 | $83.18 | $89.13 |
Anthem BCBS Setting Professional Modifier None Typical Low $30.90 Median $58.88 Typical High $79.43 | Professional | None | $30.90 | $58.88 | $79.43 |
CareSource Setting Facility Modifier None Typical Low $66.07 Median $104.71 Typical High $125.89 | Facility | None | $66.07 | $104.71 | $125.89 |
CareSource Setting Professional Modifier None Typical Low $77.62 Median $83.18 Typical High $109.65 | Professional | None | $77.62 | $83.18 | $109.65 |
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 $28.18 Median $79.43 Typical High $407.38 | Professional | None | $28.18 | $79.43 | $407.38 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $25.70 Median $77.62 Typical High $104.71 | Professional | None | $25.70 | $77.62 | $104.71 |
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 $40.74 Median $41.69 Typical High $42.66 | Professional | 52 · Reduced service | $40.74 | $41.69 | $42.66 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.22 Median $16.60 Typical High $16.98 | Professional | 53 · Discontinued | $16.22 | $16.60 | $16.98 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.30 Median $12.30 Typical High $12.88 | Professional | 55 · Aftercare only | $12.30 | $12.30 | $12.88 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.13 Median $8.32 Typical High $8.51 | Professional | 56 · Pre-op care only | $8.13 | $8.32 | $8.51 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $51.29 Median $51.29 Typical High $64.57 | Professional | GN · Speech therapy plan | $51.29 | $51.29 | $64.57 |
Where Kentucky 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.
Kentucky· 49th of 51
$66.07
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.