At Union Physical Therapy, we want you to feel confident and informed about the financial aspects of your care. Understanding your insurance benefits is a key step in this process. This page provides detailed information on the insurance plans we accept, how your plan affects your costs, and our pricing for specialized services.
Verifying Your Insurance Benefits
Before your first visit, our dedicated administrative team will contact your insurance company to verify your benefits for outpatient physical therapy. We provide this as a courtesy service to give you an initial estimate of your coverage.
However, the information we receive is not a guarantee of payment from your insurance provider. It is ultimately your responsibility to understand the specifics of your coverage. We strongly recommend that you call the member services number on the back of your insurance card to discuss your physical therapy benefits directly with your plan. This is the best way to get the most accurate and detailed information. You can also use the cost estimator tools linked below for your specific insurance company.
In-Network Insurance Plans
Being “in-network” means we have a contract with your insurance company to provide services at a negotiated rate. We are obligated to submit claims on your behalf. Union Physical Therapy is proud to be in-network with the following major insurance providers:
- Aetna
- Allied Health
- Anthem
- BCBS
- Cigna
- First Choice
- HMA
- Kaiser PPO
- Lifewise
- Meritain
- Moda
- Personify (formerly Healthcomp)
- Premera
- Regence
- Regence MedAdvantage
- Trustmark
- Triwest (requires prior authorization)
- Washington State Labor and Industries (LNI)
- Personal Injury Protection (PIP) for Motor Vehicle Collisions
Estimate Your Costs
Many insurance companies offer online tools to help you estimate your out-of-pocket expenses. Click on your provider below to access their cost estimator tool:
- Aetna: Member Payment Estimator
- Anthem: Find Care & Estimate Costs
- BCBS (CareFirst): Treatment Cost Estimator
- Cigna: myCigna Cost Estimator
- Premera: Estimate Treatment Costs
- Regence: Treatment Cost Estimator
- Triwest: TRICARE Compare Cost Tool
Out-of-Network Insurance
If we are “out-of-network” with your insurance, it means we do not have a contract with them. You can still receive care at our clinic using your out-of-network benefits, but the process is different. You will need to confirm that your plan has Out-of-Network benefits. You will be responsible for payment at the time of service (see our Self-Pay rates below). As a courtesy, our billing manager will bill your insurance for reimbursement. The reimbursement will be sent directly to you from your insurance. Note: most out-of-network plans have a high deductible. Your will not receive a reimbursement until that deductible is met.
Insurances with Out-of-Network Benefits that we can bill:
- United Healthcare (All Out of Network Plans)
Insurances We Are Not Contracted with:
We are not contracted with the following insurances, but patients may be seen on a self-pay basis:
- Medicare (all plans except Regence MedAdvantage) Medicare patients must sign an agreement stating they will not submit for reimbursement from Medicare. This agreement is known as an ABN (Advanced Beneficiary Notice).
- Medicaid (including Ambetter, Amerigroup, Community Health Plan, Coordinated Care, Molina, and United Healthcare Community Plan)
Understanding Your Out-of-Pocket Costs
Your out-of-pocket cost is determined by your specific insurance plan. Here are the key terms you need to know:
- Deductible: This is the amount you must pay for covered health care services before your insurance plan starts to pay. If you have not met your deductible for the year, you will be responsible for the full negotiated cost of your visit until it is met.
- Copay: A fixed amount you pay for a covered health care service after you’ve paid your deductible.
- Coinsurance: The percentage of costs of a covered health care service you pay after you’ve paid your deductible. For example, if your coinsurance is 20%, you pay 20% of the allowed amount, and the insurance company pays 80%.
How to Read Your Explanation of Benefits (EOB)
After your claim is processed, your insurance company will send you an Explanation of Benefits (EOB) by mail or make it available in your online portal. This document explains how your benefits were applied to your visit. The EOB is not a bill. It is a detailed summary from your insurer.
If you have questions about why a service was covered in a certain way or why a claim was denied, please call your insurance company first. The member services number is on the back of your insurance card. Since the EOB is their document, they are the best resource to explain their decisions regarding your coverage.
Here’s how to interpret the key information on your EOB:
- Charges (or “Amount Billed”): This is the full, standard price for the services you received, before any insurance discounts are applied.
- Allowed Amount: This is the maximum amount your insurance plan will pay for a covered health care service. As an in-network provider, we have a contract with your insurer for this discounted rate. All calculations are based on this number, not the original charge.
- Patient Responsibility: This is the final amount you owe. How this is calculated depends entirely on the status of your deductible.
- If your deductible has NOT been met: Your patient responsibility will be the full “Allowed Amount.” You will continue to pay this amount for each visit until your total payments meet your plan’s annual deductible.
- If your deductible HAS been met: Your patient responsibility will be your copay or coinsurance. For example, if your coinsurance is 20% and the “Allowed Amount” for a visit is $150, your patient responsibility would be $30 ($150 x 0.20).
The final bill you receive from Union Physical Therapy will match the “Patient Responsibility” amount listed on your EOB.
Pricing for Services
We believe in price transparency. Here are our self-pay rates and the costs for our specialized, out-of-pocket services.
Self-Pay Visit Pricing as of February 17th, 2026
Initial Eval/Bike Fits: $240 for 45 or 60 minute appointment
Follow-up: 60 minute = $235; 45 minute = $175
Specialized Service Pricing
Certain advanced treatments are often not covered by insurance and require out-of-pocket payment. By signing an Advance Beneficiary Notice (ABN), you agree to be financially responsible for these effective treatments.
- Functional Dry Needling:
- $30 per session. This technique uses sterile filiform needles to target myofascial trigger points, helping to relieve pain and improve muscle function.
- CPT codes: 20560 (1-2 muscles), 20561 (3 or more muscles)
- Diagnostic Ultrasound:
- $75 per session. This imaging procedure allows your therapist to visualize muscles, tendons, and joints in real-time to get a more accurate diagnosis.
- CPT code: 76882
- Focused Extracorporeal Shockwave Therapy (ESWT):
- $100 per session. This non-surgical treatment uses high-energy sound waves to stimulate healing in injured tissues that are not responding to other treatments.
- CPT code: 0101T
What Our Patients Are Saying
Frequently Asked Questions About Insurance & Pricing
Why do I have to pay extra for services like Dry Needling or Shockwave Therapy?
Many insurance companies consider these effective treatments to be “investigational” or “not medically necessary” and therefore do not cover them. To provide you with the most advanced care options, we offer these services on a self-pay basis.
Do I need a referral to see a physical therapist?
In Washington State, you can see a physical therapist without a physician referral, which is known as “Direct Access.” However, some insurance plans may still require a referral for coverage. We recommend checking with your insurance provider to be sure. We require a referral for Aetna insurance.
How can I find out what my physical therapy benefits are?
The best way to understand your benefits is to call the member services number on the back of your insurance card. You can ask about your deductible, copay, coinsurance, and whether you need a referral or authorization for physical therapy.