How much rates vary
Facilitymedian $98 · 10th to 90th $65 to $214Professionalmedian $81 · 10th to 90th $68 to $100
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 $74.13 Median $100.00 Typical High $158.49 | Facility | None | $74.13 | $100.00 | $158.49 |
Aetna Setting Professional Modifier None (both parts) Typical Low $74.13 Median $74.13 Typical High $100.00 | Professional | None (both parts) | $74.13 | $74.13 | $100.00 |
Anthem BCBS Setting Professional Modifier None (both parts) Typical Low $67.61 Median $81.28 Typical High $93.33 | Professional | None (both parts) | $67.61 | $81.28 | $93.33 |
CDPHP Setting Professional Modifier None (both parts) Typical Low $120.23 Median $120.23 Typical High $120.23 | Professional | None (both parts) | $120.23 | $120.23 | $120.23 |
Cigna Setting Facility Modifier None Typical Low $141.25 Median $186.21 Typical High $831.76 | Facility | None | $141.25 | $186.21 | $831.76 |
Cigna Setting Professional Modifier None (both parts) Typical Low $77.62 Median $91.20 Typical High $173.78 | Professional | None (both parts) | $77.62 | $91.20 | $173.78 |
Emblem Health Setting Facility Modifier None Typical Low $60.26 Median $97.72 Typical High $316.23 | Facility | None | $60.26 | $97.72 | $316.23 |
Emblem Health Setting Professional Modifier None (both parts) Typical Low $83.18 Median $83.18 Typical High $151.36 | Professional | None (both parts) | $83.18 | $83.18 | $151.36 |
Excellus BCBS Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $109.65 | Facility | None | $102.33 | $102.33 | $109.65 |
Excellus BCBS Setting Professional Modifier None (both parts) Typical Low $58.88 Median $81.28 Typical High $107.15 | Professional | None (both parts) | $58.88 | $81.28 | $107.15 |
MVP Health Care Setting Professional Modifier None (both parts) Typical Low $48.98 Median $48.98 Typical High $107.15 | Professional | None (both parts) | $48.98 | $48.98 | $107.15 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $109.65 | Facility | None | $85.11 | $85.11 | $109.65 |
United Setting Professional Modifier None (both parts) Typical Low $64.57 Median $91.20 Typical High $123.03 | Professional | None (both parts) | $64.57 | $91.20 | $123.03 |
Univera Setting Facility Modifier None Typical Low $70.79 Median $93.33 Typical High $269.15 | Facility | None | $70.79 | $93.33 | $269.15 |
Univera Setting Professional Modifier None (both parts) Typical Low $47.86 Median $81.28 Typical High $95.50 | Professional | None (both parts) | $47.86 | $81.28 | $95.50 |
10 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 $37.15 Median $37.15 Typical High $45.71 | Professional | 52 · Reduced service | $37.15 | $37.15 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $14.79 Median $14.79 Typical High $18.20 | Professional | 53 · Discontinued | $14.79 | $14.79 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.96 Median $10.96 Typical High $13.49 | Professional | 55 · Aftercare only | $10.96 | $10.96 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.41 Median $7.41 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.41 | $7.41 | $9.12 |
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 |
Excellus BCBS Setting Professional Modifier 26 · Professional part Typical Low $33.11 Median $38.90 Typical High $38.90 | Professional | 26 · Professional part | $33.11 | $38.90 | $38.90 |
Highmark BCBS Setting Facility Modifier GN · Speech therapy plan Typical Low $74.13 Median $109.65 Typical High $295.12 | Facility | GN · Speech therapy plan | $74.13 | $109.65 | $295.12 |
Highmark BCBS Setting Professional Modifier GN · Speech therapy plan Typical Low $165.96 Median $165.96 Typical High $165.96 | Professional | GN · Speech therapy plan | $165.96 | $165.96 | $165.96 |
MVP Health Care Setting Professional Modifier 53 · Discontinued Typical Low $44.67 Median $53.70 Typical High $61.66 | Professional | 53 · Discontinued | $44.67 | $53.70 | $61.66 |
Univera Setting Professional Modifier 26 · Professional part Typical Low $33.11 Median $38.90 Typical High $38.90 | Professional | 26 · Professional part | $33.11 | $38.90 | $38.90 |
Where New York 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 York· 41st of 51
$81.28
AK $186UT $64.57
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.