How much rates vary
Distribution of negotiated rates across all payers (price axis is log-scale). Small sample; interpret with caution. 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 $5.89 Median $5.89 Typical High $5.89 | Facility | None | $5.89 | $5.89 | $5.89 |
Aetna Setting Professional Modifier None Typical Low $5.25 Median $5.25 Typical High $5.25 | Professional | None | $5.25 | $5.25 | $5.25 |
CareSource Setting Professional Modifier None Typical Low $5.62 Median $5.75 Typical High $9.33 | Professional | None | $5.62 | $5.75 | $9.33 |
Cigna Setting Facility Modifier None Typical Low $9.77 Median $9.77 Typical High $100.00 | Facility | None | $9.77 | $9.77 | $100.00 |
Cigna Setting Professional Modifier None Typical Low $4.27 Median $4.79 Typical High $20.42 | Professional | None | $4.27 | $4.79 | $20.42 |
United Setting Facility Modifier None Typical Low $4.79 Median $4.79 Typical High $4.79 | Facility | None | $4.79 | $4.79 | $4.79 |
United Setting Professional Modifier None Typical Low $4.57 Median $6.03 Typical High $13.80 | Professional | None | $4.57 | $6.03 | $13.80 |
2 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 |
|---|---|---|---|---|---|
Highmark BCBS Setting Facility Modifier GO · Occupational therapy plan Typical Low $23.99 Median $25.12 Typical High $93.33 | Facility | GO · Occupational therapy plan | $23.99 | $25.12 | $93.33 |
Highmark BCBS Setting Professional Modifier GO · Occupational therapy plan + GP · Physical therapy plan Typical Low $6.31 Median $6.31 Typical High $6.31 | Professional | GO · Occupational therapy plan + GP · Physical therapy plan | $6.31 | $6.31 | $6.31 |
Where West Virginia 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.
West Virginia· 47th of 51
$5.25
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.