How much rates vary
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 Professional Modifier None Typical Low $114.82 Median $128.82 Typical High $128.82 | Professional | None | $114.82 | $128.82 | $128.82 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $57.54 Median $64.57 Typical High $64.57 | Professional | 52 · Reduced service | $57.54 | $64.57 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $22.91 Median $25.70 Typical High $25.70 | Professional | 53 · Discontinued | $22.91 | $25.70 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $16.98 Median $19.05 Typical High $19.05 | Professional | 55 · Aftercare only | $16.98 | $19.05 | $19.05 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $11.48 Median $12.88 Typical High $12.88 | Professional | 56 · Pre-op care only | $11.48 | $12.88 | $12.88 |
BCBS Alabama Setting Facility Modifier None Typical Low $56.23 Median $56.23 Typical High $56.23 | Facility | None | $56.23 | $56.23 | $56.23 |
BCBS Alabama Setting Professional Modifier 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 Typical Low $75.86 Median $104.71 Typical High $123.03 | Professional | 21 + 22 · Increased work + 24 · Unrelated visit after surgery + 31 | $75.86 | $104.71 | $123.03 |
Cigna Setting Professional Modifier None Typical Low $107.15 Median $125.89 Typical High $162.18 | Professional | None | $107.15 | $125.89 | $162.18 |
United Setting Facility Modifier None Typical Low $81.28 Median $102.33 Typical High $102.33 | Facility | None | $81.28 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $57.54 Median $97.72 Typical High $134.90 | Professional | None | $57.54 | $97.72 | $134.90 |
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 $48.98 Median $48.98 Typical High $48.98 | Professional | GN · Speech therapy plan | $48.98 | $48.98 | $48.98 |
Where Alabama sits
The same service costs 3.5 times more in Alaska than in Kentucky. 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.
Alabama· 16th 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.