How much rates vary
Facilitymedian $4,266 · 10th to 90th $126 to $8,913Professionalmedian $174 · 10th to 90th $69 to $269
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 $79.43 Median $3,981.07 Typical High $10,232.93 | Facility | None | $79.43 | $3,981.07 | $10,232.93 |
Aetna Setting Professional Modifier None Typical Low $58.88 Median $165.96 Typical High $208.93 | Professional | None | $58.88 | $165.96 | $208.93 |
Anthem BCBS Setting Facility Modifier None Typical Low $2,570.40 Median $4,466.84 Typical High $9,120.11 | Facility | None | $2,570.40 | $4,466.84 | $9,120.11 |
Anthem BCBS Setting Professional Modifier None Typical Low $154.88 Median $181.97 Typical High $257.04 | Professional | None | $154.88 | $181.97 | $257.04 |
CDPHP Setting Professional Modifier None Typical Low $93.33 Median $93.33 Typical High $275.42 | Professional | None | $93.33 | $93.33 | $275.42 |
Cigna Setting Facility Modifier None Typical Low $79.43 Median $93.33 Typical High $125.89 | Facility | None | $79.43 | $93.33 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $70.79 Median $190.55 Typical High $323.59 | Professional | None | $70.79 | $190.55 | $323.59 |
Emblem Health Setting Facility Modifier None Typical Low $60.26 Median $104.71 Typical High $213.80 | Facility | None | $60.26 | $104.71 | $213.80 |
Emblem Health Setting Professional Modifier None Typical Low $213.80 Median $239.88 Typical High $354.81 | Professional | None | $213.80 | $239.88 | $354.81 |
Excellus BCBS Setting Professional Modifier None Typical Low $138.04 Median $190.55 Typical High $251.19 | Professional | None | $138.04 | $190.55 | $251.19 |
MVP Health Care Setting Facility Modifier None Typical Low $109.65 Median $109.65 Typical High $109.65 | Facility | None | $109.65 | $109.65 | $109.65 |
MVP Health Care Setting Professional Modifier None Typical Low $208.93 Median $208.93 Typical High $489.78 | Professional | None | $208.93 | $208.93 | $489.78 |
United Setting Facility Modifier None Typical Low $53.70 Median $53.70 Typical High $70.79 | Facility | None | $53.70 | $53.70 | $70.79 |
United Setting Professional Modifier None Typical Low $50.12 Median $147.91 Typical High $275.42 | Professional | None | $50.12 | $147.91 | $275.42 |
Univera Setting Facility Modifier None Typical Low $53.70 Median $72.44 Typical High $512.86 | Facility | None | $53.70 | $72.44 | $512.86 |
Univera Setting Professional Modifier None Typical Low $138.04 Median $173.78 Typical High $251.19 | Professional | None | $138.04 | $173.78 | $251.19 |
8 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 $29.51 Median $83.18 Typical High $102.33 | Professional | 52 · Reduced service | $29.51 | $83.18 | $102.33 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $11.75 Median $33.11 Typical High $40.74 | Professional | 53 · Discontinued | $11.75 | $33.11 | $40.74 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $44.67 Median $123.03 Typical High $151.36 | Professional | 54 · Surgery only | $44.67 | $123.03 | $151.36 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $8.91 Median $24.55 Typical High $30.20 | Professional | 55 · Aftercare only | $8.91 | $24.55 | $30.20 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $5.89 Median $16.60 Typical High $20.42 | Professional | 56 · Pre-op care only | $5.89 | $16.60 | $20.42 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $154.88 Median $154.88 Typical High $154.88 | Professional | GN · Speech therapy plan | $154.88 | $154.88 | $154.88 |
Emblem Health Setting Professional Modifier GL · Free upgrade Typical Low $134.90 Median $154.88 Typical High $154.88 | Professional | GL · Free upgrade | $134.90 | $154.88 | $154.88 |
Highmark BCBS Setting Facility Modifier GN · Speech therapy plan Typical Low $100.00 Median $181.97 Typical High $645.65 | Facility | GN · Speech therapy plan | $100.00 | $181.97 | $645.65 |
Where New York sits
The same service costs 2.9 times more in Washington 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· 22nd of 51
$178
WA $288KY $100
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.