How much rates vary
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 $69.18 Median $107.15 Typical High $151.36 | Facility | None | $69.18 | $107.15 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $69.18 Median $100.00 Typical High $100.00 | Professional | None | $69.18 | $100.00 | $100.00 |
BCBS New Mexico Setting Facility Modifier None Typical Low $117.49 Median $416.87 Typical High $645.65 | Facility | None | $117.49 | $416.87 | $645.65 |
BCBS New Mexico Setting Professional Modifier None Typical Low $60.26 Median $74.13 Typical High $77.62 | Professional | None | $60.26 | $74.13 | $77.62 |
Cigna Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $141.25 | Professional | None | $74.13 | $104.71 | $141.25 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $120.23 Typical High $120.23 | Professional | None | $33.11 | $120.23 | $120.23 |
Providence Setting Facility Modifier None Typical Low $30.20 Median $107.15 Typical High $112.20 | Facility | None | $30.20 | $107.15 | $112.20 |
Providence Setting Professional Modifier None Typical Low $74.13 Median $104.71 Typical High $138.04 | Professional | None | $74.13 | $104.71 | $138.04 |
United Setting Facility Modifier None Typical Low $85.11 Median $85.11 Typical High $85.11 | Facility | None | $85.11 | $85.11 | $85.11 |
United Setting Professional Modifier None Typical Low $34.67 Median $109.65 Typical High $147.91 | Professional | None | $34.67 | $109.65 | $147.91 |
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 $34.67 Median $48.98 Typical High $48.98 | Professional | 52 · Reduced service | $34.67 | $48.98 | $48.98 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $13.80 Median $19.95 Typical High $19.95 | Professional | 53 · Discontinued | $13.80 | $19.95 | $19.95 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $10.47 Median $14.79 Typical High $14.79 | Professional | 55 · Aftercare only | $10.47 | $14.79 | $14.79 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $6.92 Median $10.00 Typical High $10.00 | Professional | 56 · Pre-op care only | $6.92 | $10.00 | $10.00 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $45.71 Median $58.88 Typical High $70.79 | Professional | GN · Speech therapy plan | $45.71 | $58.88 | $70.79 |
Where New Mexico sits
The same service costs 2.9 times more in Alaska than in Utah. 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 Mexico· 18th of 51
$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.