How much rates vary
Facilitymedian $110 · 10th to 90th $69 to $316Professionalmedian $95 · 10th to 90th $66 to $98
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 $66.07 Median $107.15 Typical High $151.36 | Facility | None | $66.07 | $107.15 | $151.36 |
Aetna Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $74.13 | Professional | None | $66.07 | $69.18 | $74.13 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $33.11 | $34.67 | $34.67 |
AmeriHealth Setting Facility Modifier None Typical Low $60.26 Median $60.26 Typical High $60.26 | Facility | None | $60.26 | $60.26 | $60.26 |
AmeriHealth Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
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 $95.50 Median $97.72 Typical High $97.72 | Professional | None | $95.50 | $97.72 | $97.72 |
Cigna Setting Professional Modifier None Typical Low $67.61 Median $79.43 Typical High $489.78 | Professional | None | $67.61 | $79.43 | $489.78 |
Emblem Health Setting Professional Modifier None Typical Low $81.28 Median $134.90 Typical High $162.18 | Professional | None | $81.28 | $134.90 | $162.18 |
Geisinger Setting Professional Modifier None Typical Low $83.18 Median $107.15 Typical High $173.78 | Professional | None | $83.18 | $107.15 | $173.78 |
Highmark BCBS Setting Facility Modifier None Typical Low $83.18 Median $194.98 Typical High $316.23 | Facility | None | $83.18 | $194.98 | $316.23 |
Independence Blue Cross Setting Professional Modifier None Typical Low $95.50 Median $95.50 Typical High $95.50 | Professional | None | $95.50 | $95.50 | $95.50 |
Martin's Point Setting Facility Modifier None Typical Low $66.07 Median $102.33 Typical High $151.36 | Facility | None | $66.07 | $102.33 | $151.36 |
Martin's Point Setting Professional Modifier None Typical Low $66.07 Median $69.18 Typical High $72.44 | Professional | None | $66.07 | $69.18 | $72.44 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $33.11 Median $34.67 Typical High $34.67 | Professional | 52 · Reduced service | $33.11 | $34.67 | $34.67 |
Oscar Health Setting Professional Modifier None Typical Low $63.10 Median $85.11 Typical High $158.49 | Professional | None | $63.10 | $85.11 | $158.49 |
UPMC Health Plan Setting Facility Modifier None Typical Low $85.11 Median $204.17 Typical High $323.59 | Facility | None | $85.11 | $204.17 | $323.59 |
UPMC Health Plan Setting Professional Modifier None Typical Low $85.11 Median $85.11 Typical High $97.72 | Professional | None | $85.11 | $85.11 | $97.72 |
United Setting Facility Modifier None Typical Low $100.00 Median $109.65 Typical High $109.65 | Facility | None | $100.00 | $109.65 | $109.65 |
United Setting Professional Modifier None Typical Low $74.13 Median $81.28 Typical High $107.15 | Professional | None | $74.13 | $81.28 | $107.15 |
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 $162.18 Median $223.87 Typical High $537.03 | Facility | GO · Occupational therapy plan | $162.18 | $223.87 | $537.03 |
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $77.62 Median $77.62 Typical High $141.25 | Professional | GO · Occupational therapy plan | $77.62 | $77.62 | $141.25 |
Highmark BCBS Setting Facility Modifier GO · Occupational therapy plan Typical Low $125.89 Median $234.42 Typical High $380.19 | Facility | GO · Occupational therapy plan | $125.89 | $234.42 | $380.19 |
Highmark BCBS Setting Professional Modifier GO · Occupational therapy plan Typical Low $77.62 Median $83.18 Typical High $89.13 | Professional | GO · Occupational therapy plan | $77.62 | $83.18 | $89.13 |
Martin's Point Setting Facility Modifier GO · Occupational therapy plan Typical Low $162.18 Median $223.87 Typical High $537.03 | Facility | GO · Occupational therapy plan | $162.18 | $223.87 | $537.03 |
Where Pennsylvania sits
The same service costs 3.3 times more in Alaska than in Florida. 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· 18th of 51
$95.50
AK $200FL $60.26
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.