Chiropractors in solo practices, small clinics, and mobile or cash-based offices bill patients for spinal adjustments, exams, X-rays, soft tissue work, and therapeutic modalities. Many bill insurance, but a growing number run cash or membership models and send itemized statements or invoices directly to patients, attorneys handling personal injury cases, or employers.
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Pricing depends on whether you bill insurance or run a cash practice. Insurance-based offices bill by CPT code and collect a copay or deductible portion from the patient, with the rest paid at contracted rates. Cash-based offices usually charge a flat fee per visit, with a higher fee for the new patient exam and X-rays. Many also sell prepaid care plans (for example 12 visits) at a discount, or monthly wellness memberships. Add-on services such as spinal decompression, massage, or cold laser are priced per session or in packages. Personal injury cases are often billed at full usual and customary rates and paid on a lien or at settlement. Supplements, braces, pillows, and orthotics are sold as separate retail line items.
| Service | Priced | Typical range |
|---|---|---|
| New patient exam and consultation | per visit | $75-250 |
| Chiropractic adjustment (established patient) | per visit | $45-100 |
| X-rays (per region, 2-3 views) | per region | $50-150 |
| Spinal decompression therapy | per session | $50-150 |
| Therapeutic massage or soft tissue work | per 30 minutes | $40-85 |
| Electrical stimulation, ultrasound, or cold laser | per session | $20-75 |
| Prepaid care plan (10-12 adjustments) | per package | $350-900 |
| Monthly wellness membership | per month | $60-150 |
Typical US ranges. Rates vary by region, experience, and job size.
| Description | Qty | Rate | Amount |
|---|---|---|---|
| New patient exam and consultation (DOS 03/04) | 1 visit | $150.00 | $150.00 |
| Lumbar spine X-rays, 3 views (DOS 03/04) | 1 region | $90.00 | $90.00 |
| Chiropractic adjustment, spinal (DOS 03/04, 03/07, 03/11, 03/14) | 4 visit | $65.00 | $260.00 |
| Electrical muscle stimulation (DOS 03/07, 03/11, 03/14) | 3 session | $30.00 | $90.00 |
| Lumbar support brace | 1 each | $55.00 | $55.00 |
| Total | $645.00 | ||
Notes: Payment due at time of service unless a payment plan is on file. Balance remaining after insurance is due within 30 days of this statement. This itemized statement can be submitted to your insurer for out-of-network reimbursement. Missed appointments without 24 hours notice may be charged $35.
Insurers, attorneys, and HSA/FSA administrators require the date of each visit, and patients often dispute charges when dates are missing.
Out-of-network reimbursement and personal injury claims depend on codes such as 98940-98942 for adjustments and the diagnosis that supports them.
Insurance carriers and HSA/FSA plans typically require these to process a claim or reimbursement.
Required on most claim submissions and helps patients claim medical expense deductions or reimbursements.
Braces, supplements, and pillows may be taxed differently than treatment in some states and are often not covered by insurance.
A clear running balance prevents confusion about what the patient still owes after insurance and prior payments.
Personal injury and auto accident billing is tied to a specific claim, and attorneys need it to match your bill to the case.
Cash-based practices usually collect at the time of service by card, HSA/FSA card, or digital payment. Insurance-based offices collect the copay or deductible portion at the visit and bill the carrier, with patient balances typically due in 30 days. Prepaid care plans are paid in full upfront or in two or three installments, and the terms should state refund rules for unused visits. Personal injury patients are often treated on a letter of protection, with payment due when the case settles, so keep clear records and send periodic ledgers to the attorney. Late fees are less common in health care; many offices instead send reminder statements and move to a collections process after 60 to 90 days, following state rules.
Balances owed by patients are much harder to collect after treatment ends. Take the copay, deductible portion, or cash fee at check-in or checkout and keep a card on file with written consent for future balances.
Before a patient buys a package, give them a written plan listing the number of visits, what is included, the total price, and how unused visits are handled. This prevents disputes when a patient stops coming.
Many patients can submit an itemized statement to their insurer or HSA/FSA. Including codes, diagnoses, and your NPI saves them time and makes them more likely to stay with your practice.
Each billed service should be supported by documentation for that date. Billing for modalities or X-rays that are not clearly noted creates audit and refund risk.
For injury cases, send updated itemized balances after each treatment phase so the attorney has current figures when negotiating a settlement.
Yes, for the patient portion such as copays, deductibles, and non-covered services. The insurer is billed separately through a claim. Show the insurance payment and adjustment on the patient statement so the balance is clear.
A superbill is an itemized statement with your provider details, CPT and diagnosis codes, dates of service, and charges. Give one to cash or out-of-network patients who want to seek reimbursement from their insurer.
Treatment is generally not taxed in most states, but retail items like braces, pillows, or supplements often are. Rules vary by state, so check with your state revenue department or an accountant.
Many practices do, as long as the policy is written, signed by the patient, and applied consistently. Some insurance contracts restrict billing patients for no-shows, so check your payer agreements.
Follow the written plan terms. Send a statement showing visits used and the remaining balance, then follow up by phone or mail. If it remains unpaid, consider a collections agency, but check your state's rules for medical debt first.
Send a Chiropractor estimate for approval, then turn it into an invoice when the work is done.
Chiropractor estimate template