How much rates vary
Facilitymedian $112 · 10th to 90th $40 to $263Professionalmedian $95 · 10th to 90th $81 to $115
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 $95.50 Median $114.82 Typical High $239.88 | Facility | None | $95.50 | $114.82 | $239.88 |
Aetna Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $109.65 | Professional | None | $95.50 | $95.50 | $109.65 |
Anthem BCBS Setting Professional Modifier None Typical Low $81.28 Median $97.72 Typical High $112.20 | Professional | None | $81.28 | $97.72 | $112.20 |
CDPHP Setting Professional Modifier None Typical Low $147.91 Median $147.91 Typical High $147.91 | Professional | None | $147.91 | $147.91 | $147.91 |
Cigna Setting Facility Modifier None Typical Low $125.89 Median $169.82 Typical High $169.82 | Facility | None | $125.89 | $169.82 | $169.82 |
Cigna Setting Professional Modifier None Typical Low $95.50 Median $112.20 Typical High $229.09 | Professional | None | $95.50 | $112.20 | $229.09 |
Emblem Health Setting Facility Modifier None Typical Low $38.02 Median $109.65 Typical High $389.05 | Facility | None | $38.02 | $109.65 | $389.05 |
Emblem Health Setting Professional Modifier None Typical Low $120.23 Median $120.23 Typical High $173.78 | Professional | None | $120.23 | $120.23 | $173.78 |
Excellus BCBS Setting Facility Modifier None Typical Low $125.89 Median $125.89 Typical High $125.89 | Facility | None | $125.89 | $125.89 | $125.89 |
Excellus BCBS Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $117.49 | Professional | None | $72.44 | $100.00 | $117.49 |
MVP Health Care Setting Facility Modifier None Typical Low $91.20 Median $91.20 Typical High $91.20 | Facility | None | $91.20 | $91.20 | $91.20 |
MVP Health Care Setting Professional Modifier None Typical Low $79.43 Median $79.43 Typical High $134.90 | Professional | None | $79.43 | $79.43 | $134.90 |
United Setting Facility Modifier None Typical Low $102.33 Median $102.33 Typical High $131.83 | Facility | None | $102.33 | $102.33 | $131.83 |
United Setting Professional Modifier None Typical Low $56.23 Median $89.13 Typical High $151.36 | Professional | None | $56.23 | $89.13 | $151.36 |
Univera Setting Facility Modifier None Typical Low $85.11 Median $112.20 Typical High $323.59 | Facility | None | $85.11 | $112.20 | $323.59 |
Univera Setting Professional Modifier None Typical Low $72.44 Median $100.00 Typical High $112.20 | Professional | None | $72.44 | $100.00 | $112.20 |
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 $47.86 Median $47.86 Typical High $54.95 | Professional | 52 · Reduced service | $47.86 | $47.86 | $54.95 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.05 Median $19.05 Typical High $21.88 | Professional | 53 · Discontinued | $19.05 | $19.05 | $21.88 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $14.45 Median $14.45 Typical High $16.60 | Professional | 55 · Aftercare only | $14.45 | $14.45 | $16.60 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $9.55 Median $9.55 Typical High $10.96 | Professional | 56 · Pre-op care only | $9.55 | $9.55 | $10.96 |
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 |
Highmark BCBS Setting Facility Modifier GN · Speech therapy plan Typical Low $165.96 Median $165.96 Typical High $165.96 | Facility | GN · Speech therapy plan | $165.96 | $165.96 | $165.96 |
Where New York 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.
New York· 45th of 51
$95.50
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.