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 $114.82 Median $114.82 Typical High $134.90 | Facility | None | $114.82 | $114.82 | $134.90 |
Aetna Setting Professional Modifier None Typical Low $114.82 Median $114.82 Typical High $131.83 | Professional | None | $114.82 | $114.82 | $131.83 |
Anthem BCBS Setting Professional Modifier None Typical Low $93.33 Median $138.04 Typical High $213.80 | Professional | None | $93.33 | $138.04 | $213.80 |
Cigna Setting Professional Modifier None Typical Low $117.49 Median $141.25 Typical High $281.84 | Professional | None | $117.49 | $141.25 | $281.84 |
Kaiser Permanente Setting Professional Modifier None Typical Low $112.20 Median $134.90 Typical High $173.78 | Professional | None | $112.20 | $134.90 | $173.78 |
United Setting Professional Modifier None Typical Low $112.20 Median $154.88 Typical High $346.74 | Professional | None | $112.20 | $154.88 | $346.74 |
6 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 $57.54 Median $57.54 Typical High $66.07 | Professional | 52 · Reduced service | $57.54 | $57.54 | $66.07 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $23.44 Median $23.44 Typical High $26.30 | Professional | 53 · Discontinued | $23.44 | $23.44 | $26.30 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $17.38 Median $17.38 Typical High $19.95 | Professional | 55 · Aftercare only | $17.38 | $17.38 | $19.95 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $11.48 Typical High $13.18 | Professional | 56 · Pre-op care only | $11.48 | $11.48 | $13.18 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $104.71 Median $104.71 Typical High $114.82 | Professional | GN · Speech therapy plan | $104.71 | $104.71 | $114.82 |
Anthem BCBS Setting Professional Modifier U1 · State-defined Typical Low $109.65 Median $109.65 Typical High $109.65 | Professional | U1 · State-defined | $109.65 | $109.65 | $109.65 |
Where Georgia sits
The same service costs 2.8 times more in Alaska than in Indiana. 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.
Georgia· 31st of 51
$135
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.