Cost is one of the first things families ask about, and the honest answer is that it depends on your child's plan of care and your coverage. This calculator does the arithmetic so you can see how the pieces fit together before you call a provider or your insurer.
Privacy: the math runs in your browser. Nothing you type is sent to us.
Your numbers
Between 5 and 40. Your child's treatment plan sets the real number. This slider is for what-if comparisons.
Placeholder, not a quote and not an average. Rates vary a lot by state, setting and provider. Enter the rate your provider gave you, or the allowed amount your insurer quotes.
Placeholder of 48 to leave room for holidays, illness and breaks. Change it to match your schedule.
Placeholder. Find yours on your insurance card or plan summary. Use the amount you still have left to pay this plan year.
Placeholder. Enter 20 if your plan pays 80% and you pay 20%.
Placeholder. Your plan documents list this. It is the most you pay in a plan year for covered in-network care.
Zero is a placeholder. Cost sharing differs by state and program, so enter an amount if yours charges one. Ask your state Medicaid office or plan.
Your estimate
- Estimated yearly cost before insurance
- $0
- Estimated family share per year
- $0
- Estimated amount covered by the plan
- $0
This is an estimate for planning, not a bill, a quote or a guarantee of coverage. It assumes in-network care, that your plan covers the hours, and that the rate you entered is the amount your plan allows.
How the math works
- Yearly cost before insurance is hours per week times hourly rate times weeks per year.
- With private insurance, you pay everything up to your deductible first.
- After the deductible, you pay your coinsurance percentage of each additional dollar, and the plan pays the rest.
- Your total for the year cannot go above your out-of-pocket maximum. Deductible and coinsurance both count toward it.
- With Medicaid, the estimate is whatever premiums or copays you enter. With self-pay, you pay the full cost.
For background on how out-of-pocket limits work, see the federal explanation at HealthCare.gov, Out-of-pocket maximum/limit. For the services and plans ABA is usually billed under, see our insurance coverage guide.
Frequently asked questions
Is this the price my provider will charge?
No. It is an estimate built from the numbers you type in. Hourly rates differ by state, provider, setting and plan, and the rate your insurer actually allows may be lower than what a provider bills. Ask the provider for their rate, and ask your insurer for the allowed amount for ABA billing codes.
What is an out-of-pocket maximum?
It is the most you pay in a plan year for covered, in-network care. Deductibles, copays and coinsurance count toward it. Once you reach it, the plan generally pays covered in-network costs for the rest of that plan year. Premiums, out-of-network charges and services your plan does not cover generally do not count.
How many hours of ABA will my child need?
That is decided by your child's assessment and treatment plan, written by a Board Certified Behavior Analyst and often reviewed by your insurer. The slider here is only for trying different numbers. Please do not treat any figure on this page as a recommendation.
Does this work for Medicaid?
Choose Medicaid in the coverage options. Cost sharing and covered hours vary by state and program, so the calculator asks you to enter any premium or copay you expect, and starts at zero as a placeholder.
Does the page save or send what I type?
No. The math runs in your browser. Nothing you enter is sent to ABA Navigator or anyone else.
Ready to talk to a provider?
Once you have a rough number, the next step is to ask providers about their rates, waitlists and which insurance they accept.
This page is general information, not financial, insurance or medical advice.