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 $23.44 Median $23.44 Typical High $61.66 | Facility | None | $23.44 | $23.44 | $61.66 |
Aetna Setting Professional Modifier None Typical Low $15.85 Median $23.44 Typical High $34.67 | Professional | None | $15.85 | $23.44 | $34.67 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $57.54 | Facility | None | $57.54 | $57.54 | $57.54 |
Cigna Setting Professional Modifier None Typical Low $20.89 Median $25.70 Typical High $61.66 | Professional | None | $20.89 | $25.70 | $61.66 |
United Setting Professional Modifier None Typical Low $26.30 Median $33.11 Typical High $46.77 | Professional | None | $26.30 | $33.11 | $46.77 |
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 GP · Physical therapy plan Typical Low $91.20 Median $154.88 Typical High $239.88 | Facility | GP · Physical therapy plan | $91.20 | $154.88 | $239.88 |
Highmark BCBS Setting Professional Modifier 59 · Distinct service + CQ · PT assistant + GO · Occupational therapy plan + GP · Physical therapy plan + GY · Excluded by law + Q6 · Substitute physician, paid per time + XU · Unusual separate service Typical Low $34.67 Median $34.67 Typical High $34.67 | Professional | 59 · Distinct service + CQ · PT assistant + GO · Occupational therapy plan + GP · Physical therapy plan + GY · Excluded by law + Q6 · Substitute physician, paid per time + XU · Unusual separate service | $34.67 | $34.67 | $34.67 |
Where Delaware sits
The same service costs 3.2 times more in Alaska than in Virginia. 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.
Delaware· 47th of 51
$25.12
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.