How much rates vary
Facilitymedian $617 · 10th to 90th $63 to $8,318Professionalmedian $186 · 10th to 90th $65 to $339
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 $177.83 Median $2,818.38 Typical High $8,511.38 | Facility | None | $177.83 | $2,818.38 | $8,511.38 |
Aetna Setting Professional Modifier None Typical Low $63.10 Median $158.49 Typical High $208.93 | Professional | None | $63.10 | $158.49 | $208.93 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $42.66 Typical High $104.71 | Professional | 52 · Reduced service | $31.62 | $42.66 | $104.71 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $16.98 Typical High $41.69 | Professional | 53 · Discontinued | $12.59 | $16.98 | $41.69 |
Aetna Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $63.10 Typical High $158.49 | Professional | 54 · Surgery only | $46.77 | $63.10 | $158.49 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $12.88 Typical High $31.62 | Professional | 55 · Aftercare only | $9.33 | $12.88 | $31.62 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.51 Typical High $20.89 | Professional | 56 · Pre-op care only | $6.31 | $8.51 | $20.89 |
AmeriHealth Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Capital Blue Cross Setting Facility Modifier None Typical Low $4,265.80 Median $5,011.87 Typical High $79,432.82 | Facility | None | $4,265.80 | $5,011.87 | $79,432.82 |
Capital Blue Cross Setting Professional Modifier None Typical Low $194.98 Median $199.53 Typical High $354.81 | Professional | None | $194.98 | $199.53 | $354.81 |
Cigna Setting Facility Modifier None Typical Low $66.07 Median $66.07 Typical High $323.59 | Facility | None | $66.07 | $66.07 | $323.59 |
Cigna Setting Professional Modifier None Typical Low $64.57 Median $154.88 Typical High $275.42 | Professional | None | $64.57 | $154.88 | $275.42 |
Emblem Health Setting Professional Modifier None Typical Low $275.42 Median $309.03 Typical High $354.81 | Professional | None | $275.42 | $309.03 | $354.81 |
Geisinger Setting Facility Modifier None Typical Low $229.09 Median $229.09 Typical High $229.09 | Facility | None | $229.09 | $229.09 | $229.09 |
Geisinger Setting Professional Modifier None Typical Low $83.18 Median $186.21 Typical High $354.81 | Professional | None | $83.18 | $186.21 | $354.81 |
Independence Blue Cross Setting Professional Modifier None Typical Low $218.78 Median $218.78 Typical High $218.78 | Professional | None | $218.78 | $218.78 | $218.78 |
Martin's Point Setting Facility Modifier None Typical Low $208.93 Median $3,630.78 Typical High $8,709.64 | Facility | None | $208.93 | $3,630.78 | $8,709.64 |
Martin's Point Setting Professional Modifier None Typical Low $63.10 Median $158.49 Typical High $208.93 | Professional | None | $63.10 | $158.49 | $208.93 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $31.62 Median $42.66 Typical High $104.71 | Professional | 52 · Reduced service | $31.62 | $42.66 | $104.71 |
Martin's Point Setting Professional Modifier 53 · Discontinued Typical Low $12.59 Median $16.98 Typical High $41.69 | Professional | 53 · Discontinued | $12.59 | $16.98 | $41.69 |
Martin's Point Setting Professional Modifier 54 · Surgery only Typical Low $46.77 Median $63.10 Typical High $158.49 | Professional | 54 · Surgery only | $46.77 | $63.10 | $158.49 |
Martin's Point Setting Professional Modifier 55 · Aftercare only Typical Low $9.33 Median $12.88 Typical High $31.62 | Professional | 55 · Aftercare only | $9.33 | $12.88 | $31.62 |
Martin's Point Setting Professional Modifier 56 · Pre-op care only Typical Low $6.31 Median $8.51 Typical High $20.89 | Professional | 56 · Pre-op care only | $6.31 | $8.51 | $20.89 |
Oscar Health Setting Professional Modifier None Typical Low $218.78 Median $257.04 Typical High $338.84 | Professional | None | $218.78 | $257.04 | $338.84 |
UPMC Health Plan Setting Facility Modifier None Typical Low $63.10 Median $269.15 Typical High $645.65 | Facility | None | $63.10 | $269.15 | $645.65 |
UPMC Health Plan Setting Professional Modifier None Typical Low $63.10 Median $186.21 Typical High $218.78 | Professional | None | $63.10 | $186.21 | $218.78 |
United Setting Facility Modifier None Typical Low $53.70 Median $58.88 Typical High $58.88 | Facility | None | $53.70 | $58.88 | $58.88 |
United Setting Professional Modifier None Typical Low $63.10 Median $138.04 Typical High $302.00 | Professional | None | $63.10 | $138.04 | $302.00 |
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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier GN · Speech therapy plan Typical Low $323.59 Median $588.84 Typical High $891.25 | Facility | GN · Speech therapy plan | $323.59 | $588.84 | $891.25 |
Where Pennsylvania 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.
Pennsylvania· 16th of 51
$186
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.