How much rates vary
Facilitymedian $126 · 10th to 90th $79 to $398Professionalmedian $85 · 10th to 90th $76 to $91
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 $85.11 Median $102.33 Typical High $186.21 | Facility | None | $85.11 | $102.33 | $186.21 |
Aetna Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $91.20 | Professional | None | $79.43 | $81.28 | $91.20 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $40.74 Typical High $45.71 | Professional | 52 · Reduced service | $39.81 | $40.74 | $45.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.22 Typical High $18.20 | Professional | 53 · Discontinued | $15.85 | $16.22 | $18.20 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.30 Typical High $13.49 | Professional | 55 · Aftercare only | $12.02 | $12.30 | $13.49 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.13 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.94 | $8.13 | $9.12 |
AmeriHealth Setting Facility Modifier None Typical Low $21.38 Median $21.38 Typical High $21.38 | Facility | None | $21.38 | $21.38 | $21.38 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $85.11 Median $87.10 Typical High $87.10 | Professional | None | $85.11 | $87.10 | $87.10 |
Cigna Setting Facility Modifier None Typical Low $114.82 Median $114.82 Typical High $114.82 | Facility | None | $114.82 | $114.82 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $25.70 Median $85.11 Typical High $158.49 | Professional | None | $25.70 | $85.11 | $158.49 |
Emblem Health Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $138.04 | Professional | None | $112.20 | $134.90 | $138.04 |
Geisinger Setting Facility Modifier None Typical Low $75.86 Median $75.86 Typical High $75.86 | Facility | None | $75.86 | $75.86 | $75.86 |
Geisinger Setting Professional Modifier None Typical Low $30.90 Median $87.10 Typical High $151.36 | Professional | None | $30.90 | $87.10 | $151.36 |
Highmark BCBS Setting Facility Modifier None Typical Low $70.79 Median $190.55 Typical High $309.03 | Facility | None | $70.79 | $190.55 | $309.03 |
Independence Blue Cross Setting Facility Modifier None Typical Low $213.80 Median $234.42 Typical High $630.96 | Facility | None | $213.80 | $234.42 | $630.96 |
Martin's Point Setting Facility Modifier None Typical Low $85.11 Median $125.89 Typical High $186.21 | Facility | None | $85.11 | $125.89 | $186.21 |
Martin's Point Setting Professional Modifier None Typical Low $79.43 Median $81.28 Typical High $91.20 | Professional | None | $79.43 | $81.28 | $91.20 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $39.81 Median $40.74 Typical High $45.71 | Professional | 52 · Reduced service | $39.81 | $40.74 | $45.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $15.85 Median $16.22 Typical High $18.20 | Professional | 53 · Discontinued | $15.85 | $16.22 | $18.20 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $12.02 Median $12.30 Typical High $13.49 | Professional | 55 · Aftercare only | $12.02 | $12.30 | $13.49 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $7.94 Median $8.13 Typical High $9.12 | Professional | 56 · Pre-op care only | $7.94 | $8.13 | $9.12 |
Oscar Health Setting Facility Modifier None Typical Low $128.82 Median $128.82 Typical High $371.54 | Facility | None | $128.82 | $128.82 | $371.54 |
Oscar Health Setting Professional Modifier None Typical Low $75.86 Median $93.33 Typical High $177.83 | Professional | None | $75.86 | $93.33 | $177.83 |
UPMC Health Plan Setting Facility Modifier None Typical Low $63.10 Median $199.53 Typical High $346.74 | Facility | None | $63.10 | $199.53 | $346.74 |
UPMC Health Plan Setting Professional Modifier None Typical Low $63.10 Median $75.86 Typical High $83.18 | Professional | None | $63.10 | $75.86 | $83.18 |
United Setting Facility Modifier None Typical Low $85.11 Median $93.33 Typical High $93.33 | Facility | None | $85.11 | $93.33 | $93.33 |
United Setting Professional Modifier None Typical Low $33.88 Median $79.43 Typical High $138.04 | Professional | None | $33.88 | $79.43 | $138.04 |
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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier GN · Speech therapy plan Typical Low $131.83 Median $213.80 Typical High $416.87 | Facility | GN · Speech therapy plan | $131.83 | $213.80 | $416.87 |
Where Pennsylvania 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.
Pennsylvania· 33rd of 51
$85.11
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.