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 $95.50 | Facility | None | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier None Typical Low $87.10 Median $87.10 Typical High $95.50 | Professional | None | $87.10 | $87.10 | $95.50 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $43.65 Median $43.65 Typical High $47.86 | Professional | 52 · Reduced service | $43.65 | $43.65 | $47.86 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $17.38 Median $17.38 Typical High $19.05 | Professional | 53 · Discontinued | $17.38 | $17.38 | $19.05 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $13.18 Median $13.18 Typical High $14.13 | Professional | 55 · Aftercare only | $13.18 | $13.18 | $14.13 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $8.71 Median $8.71 Typical High $9.55 | Professional | 56 · Pre-op care only | $8.71 | $8.71 | $9.55 |
Anthem BCBS Setting Professional Modifier None Typical Low $64.57 Median $81.28 Typical High $104.71 | Professional | None | $64.57 | $81.28 | $104.71 |
Cigna Setting Professional Modifier None Typical Low $54.95 Median $69.18 Typical High $114.82 | Professional | None | $54.95 | $69.18 | $114.82 |
Hometown Health Setting Professional Modifier None Typical Low $0.55 Median $75.86 Typical High $125.89 | Professional | None | $0.55 | $75.86 | $125.89 |
Hometown Health Setting Professional Modifier None Typical Low $0.55 Median $0.55 Typical High $125.89 | Professional | None | $0.55 | $0.55 | $125.89 |
Select Health Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $4,265.80 | Facility | None | $85.11 | $85.11 | $4,265.80 |
Select Health Setting Professional Modifier None Typical Low $57.54 Median $75.86 Typical High $85.11 | Professional | None | $57.54 | $75.86 | $85.11 |
United Setting Professional Modifier None Typical Low $33.88 Median $79.43 Typical High $109.65 | Professional | None | $33.88 | $79.43 | $109.65 |
1 more rate 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $67.61 Median $67.61 Typical High $79.43 | Professional | GN · Speech therapy plan | $67.61 | $67.61 | $79.43 |
Where Nevada 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.
Nevada· 34th of 51
$85.11
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.