Good Faith Estimate

When you see a healthcare provider, you may owe certain out-of-pocket costs, such as co-payment, coinsurance, and/or a deductible.  You may have other costs or have to pay the entire bill if you see a provider that isn’t in your health plan’s network.

The No Surprises Act of 2022 requires, under certain circumstances, health care providers to give patients who don’t have insurance or who are not using insurance an estimate of the cost of medical items and services, including outpatient rehabilitation services. 

  • Depending on when you schedule your service, your provider may be required to provide a Good Faith Estimate (GFE) between 1 and 3 business days after you schedule.
  • You can also ask your healthcare provider for a GFE before you schedule an item or service.
  • If you receive a bill that is at least $400 more than your GFE, you can dispute the bill.
  • Make sure to save a copy or picture of your GFE.

NOTE:  No Surprises Act doesn’t apply to individuals with coverage through programs such as Medicare, Medicare Advantage, Medicaid, Medigap and the Children’s Health Insurance Program (CHIP). 

For questions or more information about your right to a Good Faith Estimate,
visit  or call 1-800-985-3059

Strive Self Pay Rates
for all cases (un-insured or those choosing to not use insurance benefits):

Initial Evaluation and treatment  $130*

Follow up Sessions     $80*

*Subject to change