How much rates vary
Facilitymedian $72 · 10th to 90th $51 to $191Professionalmedian $51 · 10th to 90th $45 to $59
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 $52.48 Median $58.88 Typical High $104.71 | Facility | None | $52.48 | $58.88 | $104.71 |
Aetna Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $58.88 | Professional | None | $50.12 | $51.29 | $58.88 |
Aetna Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $25.70 Typical High $29.51 | Professional | 52 · Reduced service | $25.12 | $25.70 | $29.51 |
AmeriHealth Setting Facility Modifier None Typical Low $18.20 Median $18.20 Typical High $18.20 | Facility | None | $18.20 | $18.20 | $18.20 |
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 $50.12 Median $52.48 Typical High $52.48 | Professional | None | $50.12 | $52.48 | $52.48 |
Cigna Setting Professional Modifier None Typical Low $28.18 Median $34.67 Typical High $114.82 | Professional | None | $28.18 | $34.67 | $114.82 |
Emblem Health Setting Professional Modifier None Typical Low $66.07 Median $77.62 Typical High $83.18 | Professional | None | $66.07 | $77.62 | $83.18 |
Geisinger Setting Professional Modifier None Typical Low $47.86 Median $53.70 Typical High $89.13 | Professional | None | $47.86 | $53.70 | $89.13 |
Highmark BCBS Setting Professional Modifier None Typical Low $50.12 Median $53.70 Typical High $69.18 | Professional | None | $50.12 | $53.70 | $69.18 |
Independence Blue Cross Setting Facility Modifier None Typical Low $44.67 Median $97.72 Typical High $630.96 | Facility | None | $44.67 | $97.72 | $630.96 |
Martin's Point Setting Facility Modifier None Typical Low $51.29 Median $72.44 Typical High $104.71 | Facility | None | $51.29 | $72.44 | $104.71 |
Martin's Point Setting Professional Modifier None Typical Low $50.12 Median $51.29 Typical High $58.88 | Professional | None | $50.12 | $51.29 | $58.88 |
Martin's Point Setting Professional Modifier 52 · Reduced service Typical Low $25.12 Median $25.70 Typical High $29.51 | Professional | 52 · Reduced service | $25.12 | $25.70 | $29.51 |
Oscar Health Setting Professional Modifier None Typical Low $19.05 Median $61.66 Typical High $141.25 | Professional | None | $19.05 | $61.66 | $141.25 |
UPMC Health Plan Setting Facility Modifier None Typical Low $51.29 Median $109.65 Typical High $173.78 | Facility | None | $51.29 | $109.65 | $173.78 |
UPMC Health Plan Setting Professional Modifier None Typical Low $51.29 Median $52.48 Typical High $52.48 | Professional | None | $51.29 | $52.48 | $52.48 |
United Setting Facility Modifier None Typical Low $50.12 Median $54.95 Typical High $54.95 | Facility | None | $50.12 | $54.95 | $54.95 |
United Setting Professional Modifier None Typical Low $43.65 Median $46.77 Typical High $61.66 | Professional | None | $43.65 | $46.77 | $61.66 |
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 |
|---|---|---|---|---|---|
Ambetter Setting Professional Modifier GO · Occupational therapy plan Typical Low $38.02 Median $38.02 Typical High $38.02 | Professional | GO · Occupational therapy plan | $38.02 | $38.02 | $38.02 |
Highmark BCBS Setting Facility Modifier GO · Occupational therapy plan Typical Low $61.66 Median $117.49 Typical High $169.82 | Facility | GO · Occupational therapy plan | $61.66 | $117.49 | $169.82 |
Where Pennsylvania sits
The same service costs 3.5 times more in Alaska than in Utah. 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· 30th of 51
$51.29
AK $110UT $31.62
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.