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 $66.07 Median $97.72 Typical High $100.00 | Facility | None | $66.07 | $97.72 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $97.72 Median $100.00 Typical High $104.71 | Professional | None | $97.72 | $100.00 | $104.71 |
Anthem BCBS Setting Professional Modifier None Typical Low $10.72 Median $60.26 Typical High $83.18 | Professional | None | $10.72 | $60.26 | $83.18 |
CareSource Setting Facility Modifier None Typical Low $79.43 Median $95.50 Typical High $151.36 | Facility | None | $79.43 | $95.50 | $151.36 |
CareSource Setting Professional Modifier None Typical Low $79.43 Median $117.49 Typical High $154.88 | Professional | None | $79.43 | $117.49 | $154.88 |
Cigna Setting Facility Modifier None Typical Low $169.82 Median $169.82 Typical High $169.82 | Facility | None | $169.82 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $97.72 Typical High $489.78 | Professional | None | $64.57 | $97.72 | $489.78 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $33.11 Typical High $33.11 | Professional | None | $33.11 | $33.11 | $33.11 |
United Setting Professional Modifier None Typical Low $63.10 Median $104.71 Typical High $131.83 | Professional | None | $63.10 | $104.71 | $131.83 |
5 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 $48.98 Median $48.98 Typical High $50.12 | Professional | 52 · Reduced service | $48.98 | $48.98 | $50.12 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.50 Median $19.50 Typical High $20.42 | Professional | 53 · Discontinued | $19.50 | $19.50 | $20.42 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.79 Median $14.79 Typical High $15.14 | Professional | 55 · Aftercare only | $14.79 | $14.79 | $15.14 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.77 Median $9.77 Typical High $10.00 | Professional | 56 · Pre-op care only | $9.77 | $9.77 | $10.00 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $77.62 Median $77.62 Typical High $77.62 | Professional | GN · Speech therapy plan | $77.62 | $77.62 | $77.62 |
Where Kentucky 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.
Kentucky· 51st of 51
$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.