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 $100.00 Median $100.00 Typical High $100.00 | Facility | None | $100.00 | $100.00 | $100.00 |
Aetna Setting Professional Modifier None Typical Low $100.00 Median $144.54 Typical High $144.54 | Professional | None | $100.00 | $144.54 | $144.54 |
BCBS New Mexico Setting Facility Modifier None Typical Low $47.86 Median $169.82 Typical High $263.03 | Facility | None | $47.86 | $169.82 | $263.03 |
BCBS New Mexico Setting Professional Modifier None Typical Low $87.10 Median $107.15 Typical High $114.82 | Professional | None | $87.10 | $107.15 | $114.82 |
Cigna Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $239.88 | Professional | None | $138.04 | $186.21 | $239.88 |
Molina Setting Professional Modifier None Typical Low $33.11 Median $173.78 Typical High $173.78 | Professional | None | $33.11 | $173.78 | $173.78 |
Providence Setting Facility Modifier None Typical Low $120.23 Median $162.18 Typical High $199.53 | Facility | None | $120.23 | $162.18 | $199.53 |
Providence Setting Professional Modifier None Typical Low $138.04 Median $186.21 Typical High $239.88 | Professional | None | $138.04 | $186.21 | $239.88 |
United Setting Facility Modifier None Typical Low $123.03 Median $123.03 Typical High $123.03 | Facility | None | $123.03 | $123.03 | $123.03 |
United Setting Professional Modifier None Typical Low $131.83 Median $186.21 Typical High $229.09 | Professional | None | $131.83 | $186.21 | $229.09 |
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 $50.12 Median $72.44 Typical High $72.44 | Professional | 52 · Reduced service | $50.12 | $72.44 | $72.44 |
Aetna Setting Professional Modifier 53 · Discontinued Typical Low $19.95 Median $28.84 Typical High $28.84 | Professional | 53 · Discontinued | $19.95 | $28.84 | $28.84 |
Aetna Setting Professional Modifier 55 · Aftercare only Typical Low $15.14 Median $21.38 Typical High $21.38 | Professional | 55 · Aftercare only | $15.14 | $21.38 | $21.38 |
Aetna Setting Professional Modifier 56 · Pre-op care only Typical Low $10.00 Median $14.45 Typical High $14.45 | Professional | 56 · Pre-op care only | $10.00 | $14.45 | $14.45 |
Ambetter Setting Professional Modifier GN · Speech therapy plan Typical Low $104.71 Median $104.71 Typical High $104.71 | Professional | GN · Speech therapy plan | $104.71 | $104.71 | $104.71 |
Where New Mexico sits
The same service costs 2.8 times more in Alaska than in Indiana. 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· 13th of 51
$170
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.