How much rates vary
Facilitymedian $26 · 10th to 90th $12 to $162Professionalmedian $15 · 10th to 90th $11 to $19
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 $11.48 Median $22.91 Typical High $33.11 | Facility | None | $11.48 | $22.91 | $33.11 |
Aetna Setting Professional Modifier None Typical Low $11.48 Median $11.75 Typical High $13.80 | Professional | None | $11.48 | $11.75 | $13.80 |
AmeriHealth Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $17.78 | Professional | None | $10.72 | $10.72 | $17.78 |
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 $15.49 Median $16.22 Typical High $16.22 | Professional | None | $15.49 | $16.22 | $16.22 |
Cigna Setting Facility Modifier None Typical Low $38.90 Median $38.90 Typical High $54.95 | Facility | None | $38.90 | $38.90 | $54.95 |
Cigna Setting Professional Modifier None Typical Low $11.22 Median $13.18 Typical High $75.86 | Professional | None | $11.22 | $13.18 | $75.86 |
Emblem Health Setting Professional Modifier None Typical Low $25.70 Median $34.67 Typical High $81.28 | Professional | None | $25.70 | $34.67 | $81.28 |
Geisinger Setting Professional Modifier None Typical Low $14.79 Median $18.20 Typical High $46.77 | Professional | None | $14.79 | $18.20 | $46.77 |
Independence Blue Cross Setting Facility Modifier None Typical Low $91.20 Median $114.82 Typical High $173.78 | Facility | None | $91.20 | $114.82 | $173.78 |
Independence Blue Cross Setting Professional Modifier None Typical Low $10.72 Median $10.72 Typical High $17.78 | Professional | None | $10.72 | $10.72 | $17.78 |
Martin's Point Setting Facility Modifier None Typical Low $11.48 Median $22.91 Typical High $34.67 | Facility | None | $11.48 | $22.91 | $34.67 |
Martin's Point Setting Professional Modifier None Typical Low $11.48 Median $11.75 Typical High $13.80 | Professional | None | $11.48 | $11.75 | $13.80 |
Oscar Health Setting Professional Modifier None Typical Low $19.95 Median $38.02 Typical High $141.25 | Professional | None | $19.95 | $38.02 | $141.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $15.49 Median $89.13 Typical High $151.36 | Facility | None | $15.49 | $89.13 | $151.36 |
UPMC Health Plan Setting Professional Modifier None Typical Low $15.49 Median $15.49 Typical High $16.60 | Professional | None | $15.49 | $15.49 | $16.60 |
United Setting Facility Modifier None Typical Low $15.85 Median $17.38 Typical High $17.38 | Facility | None | $15.85 | $17.38 | $17.38 |
United Setting Professional Modifier None Typical Low $14.79 Median $15.85 Typical High $21.38 | Professional | None | $14.79 | $15.85 | $21.38 |
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 Facility Modifier GO · Occupational therapy plan Typical Low $21.38 Median $24.55 Typical High $501.19 | Facility | GO · Occupational therapy plan | $21.38 | $24.55 | $501.19 |
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $12.02 Median $12.02 Typical High $12.02 | Professional | GO · Occupational therapy plan | $12.02 | $12.02 | $12.02 |
Highmark BCBS Setting Facility Modifier GO · Occupational therapy plan Typical Low $19.50 Median $27.54 Typical High $81.28 | Facility | GO · Occupational therapy plan | $19.50 | $27.54 | $81.28 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service + GO · Occupational therapy plan + GP · Physical therapy plan Typical Low $12.02 Median $12.88 Typical High $12.88 | Professional | 59 · Distinct service + GO · Occupational therapy plan + GP · Physical therapy plan | $12.02 | $12.88 | $12.88 |
Martin's Point Setting Facility Modifier GO · Occupational therapy plan Typical Low $21.38 Median $24.55 Typical High $501.19 | Facility | GO · Occupational therapy plan | $21.38 | $24.55 | $501.19 |
Where Pennsylvania sits
The same service costs 2.7 times more in Alaska than in Ohio. 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· 36th of 51
$15.49
AK $31.62OH $11.75
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.