Life care plan cost research
Price the care in a life care plan with sourced, local rates.
Look up negotiated rates and hospital charges for each code in a plan, with the source behind every figure.
A single lookup number is hard to defend.
One plan can need hundreds of lookups, from therapy visits to imaging and surgery.
When a figure is challenged, the planner has to show which payers, providers and dates it rests on.
Build the cost basis
From plan codes to a figure a reviewer can trace.
Start with the codes and the patient's location.
Take the CPT, HCPCS or revenue codes from the plan and search each one by ZIP code, county or state near the patient.
The planner chooses the percentile the method calls for.
See the local range, not one number.
For physical therapy (CPT 97110), the BCBS of Texas median is $24.18 per 15-minute unit across 2,725 Tax IDs.
Physician usual-and-customary charges are not included.
Price facility care from the hospital's own file.
One Texas hospital's Sept. 2026 file lists a lumbar MRI (CPT 72148) at $3,650 gross, $2,190 cash and $1,613 BCBS PPO.
Document every figure
Every figure exports with its source.
Export the rows behind each selected rate to Excel, with the payer or hospital, provider, code, location and file date. A reviewer can find the same row in the published file.
Choosing the cost basis, percentile and future-cost assumptions stays with the planner.
Check each figure before it goes in the plan.
Match the rate to the service, the unit and the cost basis the method uses.
Read the common questions →Match the code and unit
Therapy codes are often priced per 15-minute unit, not per visit. Check units before applying frequency.
Use the right cost basis
Negotiated rates show what insurers pay. Gross charges and cash prices come from hospital price files.
Keep the source and date
Keep the payer, provider and file date so the figure can be checked against the published file.
Common questions
Published rates are current evidence. The plan's method decides the rest.
Can I price facility fees?
Yes, with hospital price files, which list negotiated rates, cash prices and gross charges for facility services. Physician and therapy services use payer-published negotiated rates.
Which percentiles can I see?
Results show the range of published rates with percentiles and provider counts. Choosing the percentile that fits the method is the reviewer's call.
How many codes can I look up?
As many as a plan needs. Firms pricing many plans can also use API access.
How current are the rates?
Insurer files are refreshed monthly, with history back to August 2023. Hospital price files update less often.
Does a current rate establish a future cost?
No. It is current published rate evidence. Future service needs, frequency and cost growth are part of the planning method.
Price one plan's codes
Get sourced local rates and hospital charges in one session.