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 $83.18 Median $102.33 Typical High $169.82 | Facility | None | $83.18 | $102.33 | $169.82 |
Aetna Setting Professional Modifier None Typical Low $19.05 Median $83.18 Typical High $104.71 | Professional | None | $19.05 | $83.18 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $46.77 Median $64.57 Typical High $112.20 | Professional | None | $46.77 | $64.57 | $112.20 |
BCBS Kansas City Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $95.50 | Professional | None | $85.11 | $89.13 | $95.50 |
Cigna Setting Facility Modifier None Typical Low $131.83 Median $131.83 Typical High $131.83 | Facility | None | $131.83 | $131.83 | $131.83 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $87.10 Typical High $162.18 | Professional | None | $70.79 | $87.10 | $162.18 |
Medica Setting Facility Modifier None Typical Low $83.18 Median $112.20 Typical High $389.05 | Facility | None | $83.18 | $112.20 | $389.05 |
Medica Setting Professional Modifier None Typical Low $79.43 Median $120.23 Typical High $537.03 | Professional | None | $79.43 | $120.23 | $537.03 |
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 $67.61 Median $102.33 Typical High $213.80 | Professional | None | $67.61 | $102.33 | $213.80 |
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 $41.69 Median $44.67 Typical High $52.48 | Professional | 52 · Reduced service | $41.69 | $44.67 | $52.48 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $16.98 Median $17.78 Typical High $20.89 | Professional | 53 · Discontinued | $16.98 | $17.78 | $20.89 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.59 Median $13.18 Typical High $15.49 | Professional | 55 · Aftercare only | $12.59 | $13.18 | $15.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.32 Median $8.91 Typical High $10.47 | Professional | 56 · Pre-op care only | $8.32 | $8.91 | $10.47 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $58.88 Median $63.10 Typical High $66.07 | Professional | GN · Speech therapy plan | $58.88 | $63.10 | $66.07 |
Where Missouri 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.
Missouri· 43rd of 51
$79.43
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.