How much rates vary
Facilitymedian $9 · 10th to 90th $4 to $132Professionalmedian $7 · 10th to 90th $4 to $8
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 $3.89 Median $8.51 Typical High $14.79 | Facility | None | $3.89 | $8.51 | $14.79 |
Aetna Setting Professional Modifier None Typical Low $3.80 Median $3.89 Typical High $7.24 | Professional | None | $3.80 | $3.89 | $7.24 |
AmeriHealth Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
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 $6.92 Median $7.24 Typical High $7.24 | Professional | None | $6.92 | $7.24 | $7.24 |
Cigna Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $61.66 | Facility | None | $18.20 | $18.20 | $61.66 |
Cigna Setting Professional Modifier None Typical Low $3.80 Median $4.79 Typical High $32.36 | Professional | None | $3.80 | $4.79 | $32.36 |
Emblem Health Setting Professional Modifier None Typical Low $9.77 Median $34.67 Typical High $81.28 | Professional | None | $9.77 | $34.67 | $81.28 |
Geisinger Setting Professional Modifier None Typical Low $5.75 Median $7.94 Typical High $22.39 | Professional | None | $5.75 | $7.94 | $22.39 |
Highmark BCBS Setting Facility Modifier None Typical Low $8.13 Median $10.23 Typical High $14.13 | Facility | None | $8.13 | $10.23 | $14.13 |
Highmark BCBS Setting Professional Modifier None Typical Low $4.90 Median $4.90 Typical High $4.90 | Professional | None | $4.90 | $4.90 | $4.90 |
Independence Blue Cross Setting Facility Modifier None Typical Low $109.65 Median $125.89 Typical High $251.19 | Facility | None | $109.65 | $125.89 | $251.19 |
Independence Blue Cross Setting Professional Modifier None Typical Low $4.37 Median $4.37 Typical High $4.37 | Professional | None | $4.37 | $4.37 | $4.37 |
Martin's Point Setting Facility Modifier None Typical Low $3.80 Median $7.94 Typical High $16.22 | Facility | None | $3.80 | $7.94 | $16.22 |
Martin's Point Setting Professional Modifier None Typical Low $3.80 Median $3.89 Typical High $7.08 | Professional | None | $3.80 | $3.89 | $7.08 |
Oscar Health Setting Professional Modifier None Typical Low $7.24 Median $17.78 Typical High $107.15 | Professional | None | $7.24 | $17.78 | $107.15 |
UPMC Health Plan Setting Facility Modifier None Typical Low $5.50 Median $64.57 Typical High $109.65 | Facility | None | $5.50 | $64.57 | $109.65 |
UPMC Health Plan Setting Professional Modifier None Typical Low $5.50 Median $7.08 Typical High $7.08 | Professional | None | $5.50 | $7.08 | $7.08 |
United Setting Facility Modifier None Typical Low $6.03 Median $6.61 Typical High $6.61 | Facility | None | $6.03 | $6.61 | $6.61 |
United Setting Professional Modifier None Typical Low $5.01 Median $5.89 Typical High $9.55 | Professional | None | $5.01 | $5.89 | $9.55 |
3 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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $4.57 Median $4.57 Typical High $4.57 | Professional | GO · Occupational therapy plan | $4.57 | $4.57 | $4.57 |
Highmark BCBS Setting Facility Modifier GO · Occupational therapy plan Typical Low $7.41 Median $12.88 Typical High $50.12 | Facility | GO · Occupational therapy plan | $7.41 | $12.88 | $50.12 |
Highmark BCBS Setting Professional Modifier GO · Occupational therapy plan Typical Low $4.57 Median $5.01 Typical High $6.92 | Professional | GO · Occupational therapy plan | $4.57 | $5.01 | $6.92 |
Where Pennsylvania sits
The same service costs 2.6 times more in North Dakota than in Missouri. 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· 21st of 51
$6.92
ND $12.02MO $4.68
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.