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 $42.66 Median $95.50 Typical High $154.88 | Facility | None | $42.66 | $95.50 | $154.88 |
Aetna Setting Professional Modifier None Typical Low $91.20 Median $95.50 Typical High $95.50 | Professional | None | $91.20 | $95.50 | $95.50 |
Anthem BCBS Setting Professional Modifier None Typical Low $91.20 Median $125.89 Typical High $162.18 | Professional | None | $91.20 | $125.89 | $162.18 |
Cigna Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $128.82 | Facility | None | $128.82 | $128.82 | $128.82 |
Cigna Setting Professional Modifier None Typical Low $85.11 Median $89.13 Typical High $173.78 | Professional | None | $85.11 | $89.13 | $173.78 |
Harvard Pilgrim Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $208.93 | Professional | None | $93.33 | $93.33 | $208.93 |
United Setting Professional Modifier None Typical Low $75.86 Median $117.49 Typical High $223.87 | Professional | None | $75.86 | $117.49 | $223.87 |
Well Sense Setting Professional Modifier None Typical Low $43.65 Median $43.65 Typical High $77.62 | Professional | None | $43.65 | $43.65 | $77.62 |
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 $45.71 Median $47.86 Typical High $47.86 | Professional | 52 · Reduced service | $45.71 | $47.86 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $18.20 Median $19.50 Typical High $19.50 | Professional | 53 · Discontinued | $18.20 | $19.50 | $19.50 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.80 Median $14.45 Typical High $14.45 | Professional | 55 · Aftercare only | $13.80 | $14.45 | $14.45 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.12 Median $9.55 Typical High $9.55 | Professional | 56 · Pre-op care only | $9.12 | $9.55 | $9.55 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $69.18 Median $69.18 Typical High $69.18 | Professional | GN · Speech therapy plan | $69.18 | $69.18 | $69.18 |
Where New Hampshire 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.
New Hampshire· 6th of 51
$126
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.