How much rates vary
Facilitymedian $191 · 10th to 90th $87 to $661Professionalmedian $93 · 10th to 90th $68 to $363
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 $114.82 Median $128.82 Typical High $151.36 | Facility | None | $114.82 | $128.82 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $107.15 Median $123.03 Typical High $151.36 | Professional | None | $107.15 | $123.03 | $151.36 |
Anthem BCBS Setting Facility Modifier None Typical Low $87.10 Median $109.65 Typical High $457.09 | Facility | None | $87.10 | $109.65 | $457.09 |
Anthem BCBS Setting Professional Modifier None Typical Low $75.86 Median $89.13 Typical High $173.78 | Professional | None | $75.86 | $89.13 | $173.78 |
Blue Shield Setting Facility Modifier None Typical Low $125.89 Median $426.58 Typical High $776.25 | Facility | None | $125.89 | $426.58 | $776.25 |
Blue Shield Setting Professional Modifier None Typical Low $47.86 Median $67.61 Typical High $93.33 | Professional | None | $47.86 | $67.61 | $93.33 |
Central California Alliance for Health Setting Professional Modifier None Typical Low $77.62 Median $117.49 Typical High $144.54 | Professional | None | $77.62 | $117.49 | $144.54 |
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 $79.43 Median $117.49 Typical High $181.97 | Professional | None | $79.43 | $117.49 | $181.97 |
Contra Costa Health Setting Professional Modifier None Typical Low $52.48 Median $128.82 Typical High $154.88 | Professional | None | $52.48 | $128.82 | $154.88 |
Kaiser Permanente Setting Professional Modifier None Typical Low $85.11 Median $114.82 Typical High $199.53 | Professional | None | $85.11 | $114.82 | $199.53 |
Lucent Health Setting Professional Modifier None Typical Low $660.69 Median $851.14 Typical High $851.14 | Professional | None | $660.69 | $851.14 | $851.14 |
Molina Setting Professional Modifier None Typical Low $57.54 Median $57.54 Typical High $144.54 | Professional | None | $57.54 | $57.54 | $144.54 |
Optum Setting Professional Modifier None Typical Low $30.90 Median $54.95 Typical High $70.79 | Professional | None | $30.90 | $54.95 | $70.79 |
Providence Setting Facility Modifier None Typical Low $114.82 Median $151.36 Typical High $194.98 | Facility | None | $114.82 | $151.36 | $194.98 |
Providence Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $181.97 | Professional | None | $79.43 | $117.49 | $181.97 |
Sutter Health Plus Setting Professional Modifier None Typical Low $363.08 Median $363.08 Typical High $363.08 | Professional | None | $363.08 | $363.08 | $363.08 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $102.33 | Facility | None | $102.33 | $102.33 | $102.33 |
United Setting Professional Modifier None Typical Low $75.86 Median $95.50 Typical High $186.21 | Professional | None | $75.86 | $95.50 | $186.21 |
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 $52.48 Median $57.54 Typical High $64.57 | Professional | 52 · Reduced service | $52.48 | $57.54 | $64.57 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $21.38 Median $22.91 Typical High $25.70 | Professional | 53 · Discontinued | $21.38 | $22.91 | $25.70 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.85 Median $16.98 Typical High $19.50 | Professional | 55 · Aftercare only | $15.85 | $16.98 | $19.50 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.47 Median $11.48 Typical High $12.88 | Professional | 56 · Pre-op care only | $10.47 | $11.48 | $12.88 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $48.98 Median $81.28 Typical High $97.72 | Professional | GN · Speech therapy plan | $48.98 | $81.28 | $97.72 |
HealthNet Setting Professional Modifier GN · Speech therapy plan Typical Low $87.10 Median $87.10 Typical High $87.10 | Professional | GN · Speech therapy plan | $87.10 | $87.10 | $87.10 |
Where California 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.
California· 46th of 51
$93.33
AK $224KY $63.10
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.