Low-Level Laser Therapy
What Medicare pays for 0552T, what providers bill, and how the price varies across 2 states, drawn from CMS 2023 claims data.
0552T · the short answer
For low-level laser therapy, Medicare pays about $4.64 on average across 2 states. This is a low-payment administrative or drug code, so the billed-to-paid ratio is not a meaningful "markup."
- Medicare pays
- $4.64
- Providers bill
- $44.43
- States with data
- 2
Medicare amounts are CMS-published; markup = average submitted charge ÷ average Medicare payment.
Price Range Across States
What You Might Pay
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
How we estimate these prices
These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Other procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.
Prices by State
| State | Medicare Payment | Billed Charge |
|---|---|---|
| California | $5.30 | $97.50 |
| Texas | $4.38 | $15.00 |
What the Data Says About Low-Level Laser Therapy
Across 2 states with reporting providers, CPT code 0552T (Low-Level Laser Therapy) shows a national average Medicare payment of $4.64 against an average billed charge of $44.43. That gap, a 9.6x markup, or 858% above the Medicare allowed amount, is not a meaningful ratio for this low-payment code, so treat the billed figure as a chargemaster reference point rather than a real-world price.
Other procedures like this one saw 348 services billed to Medicare in 2023 by 14 distinct providers, serving 70 unique beneficiaries. State-level variation is significant: Texas reports the lowest average payment at $4.38, while California reports the highest at $5.30. The 21% spread here is a moderate, fairly ordinary GPCI effect, local cost-of-practice adjustments nudging the allowed amount up or down without reshaping it.
Applying RAND 2024 commercial-to-Medicare ratios specific to the Other category (2.24x), the estimated commercial insurance price lands near $13.08, with self-pay cash discounts commonly bringing the figure closer to $16.60. Within Other, Low-Level Laser Therapy ranks #142 of 151 tracked procedures by national average Medicare payment.
What to do with this
If you may have low-level laser therapy done, these steps turn the numbers above into a real-world cost estimate.
- Request a Good Faith Estimate from your provider at least 3 business days before a scheduled procedure, under the No Surprises Act it is an enforceable written price.
- Compare low-level laser therapy costs in your state, Medicare rates vary by locality. Browse states
- Check a hospital’s published cash price, which is often far below the billed charge. Price transparency
- Understand why billed charges run several times the Medicare rate before you negotiate. Read the guide
Figures here are averages and estimates, not a quote. Confirm coverage and out-of-pocket costs with your insurer and provider.
Frequently Asked Questions
How much does Low-Level Laser Therapy cost?
Low-Level Laser Therapy (CPT 0552T) is priced fairly consistently nationwide: Medicare pays $4.64 on average, and the $4.38-$5.30 state range stays relatively tight. Providers typically bill $44.43.
Why do providers charge more than Medicare pays?
Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.
How much does Low-Level Laser Therapy cost with insurance?
With commercial insurance, low-level laser therapy costs an estimated $13.08 on average (range: $9.15-$18.31), a moderate premium over Medicare's $4.64. Without insurance, the estimated cash price is $16.60.
Which state has the lowest cost for Low-Level Laser Therapy?
Texas and California bookend the range for Low-Level Laser Therapy, at $4.38 and $5.30 respectively - a relatively tight $0.92 spread nationwide.
How many providers perform Low-Level Laser Therapy?
Low-Level Laser Therapy is comparatively uncommon: only 14 providers nationally billed Medicare for it in 2023, serving 70 beneficiaries via 348 total services.
What is the billed-to-Medicare markup for Low-Level Laser Therapy?
Providers bill 9.6x what Medicare pays for Low-Level Laser Therapy - a markup within the typical range at 858% above the Medicare rate.
Related Guides
Tips to reduce out-of-pocket costs
Your right to upfront pricing
How Medicare payments work
Decode charges and codes
Why bills exceed actual costs
Geographic pricing factors
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology - how this data is sourced, computed, and verified.
Related
Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.