How much rates vary
Facilitymedian $41 · 10th to 90th $19 to $115Professionalmedian $19 · 10th to 90th $18 to $35
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 $17.78 Median $31.62 Typical High $50.12 | Facility | None | $17.78 | $31.62 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $17.78 Median $18.62 Typical High $27.54 | Professional | None | $17.78 | $18.62 | $27.54 |
AmeriHealth Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
AmeriHealth Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $26.92 | Professional | None | $16.22 | $16.22 | $26.92 |
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 $32.36 Median $34.67 Typical High $63.10 | Professional | None | $32.36 | $34.67 | $63.10 |
Cigna Setting Facility Modifier None Typical Low $50.12 Median $50.12 Typical High $125.89 | Facility | None | $50.12 | $50.12 | $125.89 |
Cigna Setting Professional Modifier None Typical Low $18.20 Median $22.39 Typical High $134.90 | Professional | None | $18.20 | $22.39 | $134.90 |
Emblem Health Setting Professional Modifier None Typical Low $34.67 Median $38.02 Typical High $81.28 | Professional | None | $34.67 | $38.02 | $81.28 |
Geisinger Setting Professional Modifier None Typical Low $25.70 Median $31.62 Typical High $57.54 | Professional | None | $25.70 | $31.62 | $57.54 |
Highmark BCBS Setting Facility Modifier None Typical Low $17.78 Median $52.48 Typical High $77.62 | Facility | None | $17.78 | $52.48 | $77.62 |
Highmark BCBS Setting Professional Modifier None Typical Low $21.38 Median $23.44 Typical High $25.70 | Professional | None | $21.38 | $23.44 | $25.70 |
Independence Blue Cross Setting Facility Modifier None Typical Low $45.71 Median $97.72 Typical High $870.96 | Facility | None | $45.71 | $97.72 | $870.96 |
Independence Blue Cross Setting Professional Modifier None Typical Low $16.22 Median $16.22 Typical High $36.31 | Professional | None | $16.22 | $16.22 | $36.31 |
Martin's Point Setting Facility Modifier None Typical Low $17.78 Median $29.51 Typical High $52.48 | Facility | None | $17.78 | $29.51 | $52.48 |
Martin's Point Setting Professional Modifier None Typical Low $17.78 Median $18.62 Typical High $25.12 | Professional | None | $17.78 | $18.62 | $25.12 |
Oscar Health Setting Professional Modifier None Typical Low $10.00 Median $54.95 Typical High $89.13 | Professional | None | $10.00 | $54.95 | $89.13 |
UPMC Health Plan Setting Facility Modifier None Typical Low $26.30 Median $66.07 Typical High $114.82 | Facility | None | $26.30 | $66.07 | $114.82 |
UPMC Health Plan Setting Professional Modifier None Typical Low $26.30 Median $28.18 Typical High $28.18 | Professional | None | $26.30 | $28.18 | $28.18 |
United Setting Facility Modifier None Typical Low $27.54 Median $30.20 Typical High $30.20 | Facility | None | $27.54 | $30.20 | $30.20 |
United Setting Professional Modifier None Typical Low $22.91 Median $25.12 Typical High $33.11 | Professional | None | $22.91 | $25.12 | $33.11 |
14 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 59 · Distinct service Typical Low $44.67 Median $60.26 Typical High $213.80 | Facility | 59 · Distinct service | $44.67 | $60.26 | $213.80 |
Aetna Setting Facility Modifier CQ · PT assistant Typical Low $40.74 Median $48.98 Typical High $81.28 | Facility | CQ · PT assistant | $40.74 | $48.98 | $81.28 |
Aetna Setting Facility Modifier GO · Occupational therapy plan Typical Low $7.24 Median $95.50 Typical High $275.42 | Facility | GO · Occupational therapy plan | $7.24 | $95.50 | $275.42 |
Aetna Setting Facility Modifier GP · Physical therapy plan Typical Low $47.86 Median $89.13 Typical High $138.04 | Facility | GP · Physical therapy plan | $47.86 | $89.13 | $138.04 |
Ambetter Setting Professional Modifier 59 · Distinct service Typical Low $21.38 Median $21.38 Typical High $22.91 | Professional | 59 · Distinct service | $21.38 | $21.38 | $22.91 |
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $19.05 Median $19.05 Typical High $53.70 | Professional | GO · Occupational therapy plan | $19.05 | $19.05 | $53.70 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $19.05 Median $19.05 Typical High $22.91 | Professional | GP · Physical therapy plan | $19.05 | $19.05 | $22.91 |
Highmark BCBS Setting Facility Modifier GO · Occupational therapy plan Typical Low $33.11 Median $53.70 Typical High $107.15 | Facility | GO · Occupational therapy plan | $33.11 | $53.70 | $107.15 |
Highmark BCBS Setting Facility Modifier GP · Physical therapy plan Typical Low $27.54 Median $50.12 Typical High $91.20 | Facility | GP · Physical therapy plan | $27.54 | $50.12 | $91.20 |
Highmark BCBS Setting Professional Modifier GP · Physical therapy plan Typical Low $21.88 Median $24.55 Typical High $31.62 | Professional | GP · Physical therapy plan | $21.88 | $24.55 | $31.62 |
Martin's Point Setting Facility Modifier 59 · Distinct service Typical Low $44.67 Median $60.26 Typical High $213.80 | Facility | 59 · Distinct service | $44.67 | $60.26 | $213.80 |
Martin's Point Setting Facility Modifier CQ · PT assistant Typical Low $40.74 Median $48.98 Typical High $81.28 | Facility | CQ · PT assistant | $40.74 | $48.98 | $81.28 |
Martin's Point Setting Facility Modifier GO · Occupational therapy plan Typical Low $7.24 Median $95.50 Typical High $275.42 | Facility | GO · Occupational therapy plan | $7.24 | $95.50 | $275.42 |
Martin's Point Setting Facility Modifier GP · Physical therapy plan Typical Low $47.86 Median $91.20 Typical High $138.04 | Facility | GP · Physical therapy plan | $47.86 | $91.20 | $138.04 |
Where Pennsylvania sits
The same service costs 3.0 times more in Minnesota 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· 47th of 51
$18.62
MN $53.70OH $17.78
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.