How much rates vary
Facilitymedian $45 · 10th to 90th $22 to $112Professionalmedian $23 · 10th to 90th $22 to $42
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 $21.88 Median $38.90 Typical High $50.12 | Facility | None | $21.88 | $38.90 | $50.12 |
Aetna Setting Professional Modifier None Typical Low $21.38 Median $22.39 Typical High $28.84 | Professional | None | $21.38 | $22.39 | $28.84 |
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 $14.79 Median $14.79 Typical High $33.11 | Professional | None | $14.79 | $14.79 | $33.11 |
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 $38.02 Median $40.74 Typical High $85.11 | Professional | None | $38.02 | $40.74 | $85.11 |
Cigna Setting Facility Modifier None Typical Low $57.54 Median $57.54 Typical High $89.13 | Facility | None | $57.54 | $57.54 | $89.13 |
Cigna Setting Professional Modifier None Typical Low $21.88 Median $26.30 Typical High $154.88 | Professional | None | $21.88 | $26.30 | $154.88 |
Emblem Health Setting Professional Modifier None Typical Low $42.66 Median $44.67 Typical High $81.28 | Professional | None | $42.66 | $44.67 | $81.28 |
Geisinger Setting Professional Modifier None Typical Low $29.51 Median $36.31 Typical High $67.61 | Professional | None | $29.51 | $36.31 | $67.61 |
Highmark BCBS Setting Facility Modifier None Typical Low $10.96 Median $48.98 Typical High $158.49 | Facility | None | $10.96 | $48.98 | $158.49 |
Independence Blue Cross Setting Facility Modifier None Typical Low $17.38 Median $48.98 Typical High $1,258.93 | Facility | None | $17.38 | $48.98 | $1,258.93 |
Independence Blue Cross Setting Professional Modifier None Typical Low $14.79 Median $14.79 Typical High $33.11 | Professional | None | $14.79 | $14.79 | $33.11 |
Martin's Point Setting Facility Modifier None Typical Low $21.88 Median $38.90 Typical High $57.54 | Facility | None | $21.88 | $38.90 | $57.54 |
Martin's Point Setting Professional Modifier None Typical Low $21.38 Median $22.39 Typical High $26.30 | Professional | None | $21.38 | $22.39 | $26.30 |
Oscar Health Setting Professional Modifier None Typical Low $33.88 Median $63.10 Typical High $107.15 | Professional | None | $33.88 | $63.10 | $107.15 |
UPMC Health Plan Setting Facility Modifier None Typical Low $29.51 Median $69.18 Typical High $117.49 | Facility | None | $29.51 | $69.18 | $117.49 |
UPMC Health Plan Setting Professional Modifier None Typical Low $29.51 Median $29.51 Typical High $32.36 | Professional | None | $29.51 | $29.51 | $32.36 |
United Setting Facility Modifier None Typical Low $32.36 Median $35.48 Typical High $35.48 | Facility | None | $32.36 | $35.48 | $35.48 |
United Setting Professional Modifier None Typical Low $26.92 Median $29.51 Typical High $39.81 | Professional | None | $26.92 | $29.51 | $39.81 |
8 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 $53.70 Median $81.28 Typical High $346.74 | Facility | GO · Occupational therapy plan | $53.70 | $81.28 | $346.74 |
Aetna Setting Facility Modifier GP · Physical therapy plan Typical Low $54.95 Median $75.86 Typical High $295.12 | Facility | GP · Physical therapy plan | $54.95 | $75.86 | $295.12 |
Ambetter Setting Professional Modifier GP · Physical therapy plan Typical Low $18.62 Median $22.39 Typical High $45.71 | Professional | GP · Physical therapy plan | $18.62 | $22.39 | $45.71 |
Highmark BCBS Setting Facility Modifier GO · Occupational therapy plan Typical Low $33.88 Median $66.07 Typical High $107.15 | Facility | GO · Occupational therapy plan | $33.88 | $66.07 | $107.15 |
Highmark BCBS Setting Facility Modifier GP · Physical therapy plan Typical Low $45.71 Median $77.62 Typical High $114.82 | Facility | GP · Physical therapy plan | $45.71 | $77.62 | $114.82 |
Highmark BCBS Setting Professional Modifier 25 · Same-day visit + 59 · Distinct service + CQ · PT assistant + GO · Occupational therapy plan + GP · Physical therapy plan + XS · Separate structure Typical Low $26.92 Median $26.92 Typical High $26.92 | Professional | 25 · Same-day visit + 59 · Distinct service + CQ · PT assistant + GO · Occupational therapy plan + GP · Physical therapy plan + XS · Separate structure | $26.92 | $26.92 | $26.92 |
Martin's Point Setting Facility Modifier GO · Occupational therapy plan Typical Low $53.70 Median $79.43 Typical High $346.74 | Facility | GO · Occupational therapy plan | $53.70 | $79.43 | $346.74 |
Martin's Point Setting Facility Modifier GP · Physical therapy plan Typical Low $54.95 Median $74.13 Typical High $295.12 | Facility | GP · Physical therapy plan | $54.95 | $74.13 | $295.12 |
Where Pennsylvania sits
The same service costs 3.0 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· 47th of 51
$22.91
AK $63.10OH $20.89
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.