How much does age-in-place modifications cost?

Short answer

$150 - $400 USD per installed grab bar, $3,000 - $6,000 for stair lifts, and $8,000 - $15,000 for curbless showers.

Contractors and specialists who adapt homes with grab bars, ramps, stair lifts, and safer bathrooms.

What moves the price

  • Travel distance from the provider to the home, and whether a travel fee or minimum visit applies.
  • How complex the job is: a single grab bar is very different from a curbless shower conversion.
  • Whether the work is one visit or a recurring schedule, since regular clients usually get a lower rate.
  • Local labour rates, which run well above average in the largest metros.
  • Materials and equipment, which are quoted separately by most independent specialists.

City by city

Age-in-Place Modifications in New York, NY

Rates in the five boroughs typically run 15 to 25 percent above the national average, and many providers set a two-hour minimum visit.

Age-in-Place Modifications in Chicago, IL

Chicago pricing sits close to the national midpoint, with modest travel surcharges for suburban visits.

Age-in-Place Modifications in Phoenix, AZ

Metro Phoenix rates trend slightly below the national average, though seasonal demand rises in the winter months.

Age-in-Place Modifications in Miami, FL

Miami-Dade rates run near or slightly above the national average, with bilingual service widely available.

Age-in-Place Modifications in Los Angeles, CA

Los Angeles pricing is among the highest in the US, and long cross-town drive times often add a travel fee.

Age-in-Place Modifications in Las Vegas, NV

Las Vegas rates run close to or slightly below the national average, and the absence of a state income tax keeps overall costs of care competitive for the region.

Age-in-Place Modifications in San Francisco, CA

San Francisco is among the most expensive markets in the country for in-home care, commonly 30 percent or more above the national average.

Age-in-Place Modifications in Charlotte, NC

Charlotte pricing sits modestly below the national average, reflecting the broader Carolinas cost of living.

Age-in-Place Modifications in Indianapolis, IN

Indianapolis is one of the more affordable major metros for in-home care, typically running below the national average.

Age-in-Place Modifications in San Diego, CA

San Diego rates run above the national average, in line with coastal California's higher cost of living.

Age-in-Place Modifications in San Jose, CA

San Jose and the wider Silicon Valley area post some of the highest in-home care rates in the country, well above the national average.

Age-in-Place Modifications in Austin, TX

Austin rates have climbed above the national average in recent years alongside the metro's rapid growth.

Age-in-Place Modifications in Houston, TX

Houston pricing runs close to the national average, among the more affordable large metros in the country.

Age-in-Place Modifications in San Antonio, TX

San Antonio is one of the more affordable large Texas metros for in-home care, typically at or below the national average.

Age-in-Place Modifications in Sacramento, CA

Sacramento rates run above the national average but well below the San Francisco Bay Area, a relatively more affordable option within California.

Age-in-Place Modifications in Denver, CO

Denver rates run close to or slightly above the national average, reflecting the Front Range's rising cost of living.

Age-in-Place Modifications in Washington, DC

Washington, DC rates run above the national average, in line with the region's higher cost of living.

Age-in-Place Modifications in Orlando, FL

Orlando pricing runs close to or slightly below the national average, among the more affordable major Florida metros.

Age-in-Place Modifications in Tampa, FL

Tampa Bay rates run near the national average, with bilingual service widely available.

Age-in-Place Modifications in Atlanta, GA

Atlanta pricing sits close to the national average, though rates trend higher inside the Perimeter.

Age-in-Place Modifications in Boston, MA

Boston is among the more expensive markets in the country for in-home care, commonly above the national average.

Age-in-Place Modifications in Baltimore, MD

Baltimore rates run close to the national average, modestly below nearby Washington, DC.

Age-in-Place Modifications in Detroit, MI

Detroit is one of the more affordable major metros for in-home care, typically running below the national average.

Age-in-Place Modifications in Minneapolis, MN

Minneapolis-St. Paul pricing sits close to the national average.

Age-in-Place Modifications in Kansas City, MO

Kansas City is one of the more affordable major metros for in-home care, typically below the national average.

Age-in-Place Modifications in St. Louis, MO

St. Louis pricing runs below the national average, among the more affordable major Midwest metros.

Age-in-Place Modifications in Cincinnati, OH

Cincinnati rates run below the national average, among the more affordable major Ohio metros.

Age-in-Place Modifications in Columbus, OH

Columbus pricing sits close to the national average.

Age-in-Place Modifications in Portland, OR

Portland rates run above the national average, in line with the broader Pacific Northwest cost of living.

Age-in-Place Modifications in Philadelphia, PA

Philadelphia pricing runs close to or slightly above the national average.

Age-in-Place Modifications in Pittsburgh, PA

Pittsburgh is one of the more affordable major metros for in-home care, typically below the national average.

Age-in-Place Modifications in Nashville, TN

Nashville rates have climbed toward the national average alongside the metro's rapid growth.

Age-in-Place Modifications in Dallas, TX

Dallas-Fort Worth pricing runs close to the national average, among the more moderate large Texas metros.

Age-in-Place Modifications in Seattle, WA

Seattle is among the more expensive markets in the country for in-home care, commonly above the national average.

Age-in-Place Modifications in Milwaukee, WI

Milwaukee pricing runs below the national average, among the more affordable major Midwest metros.

Age-in-Place Modifications in Oklahoma City, OK

Oklahoma City rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Tulsa, OK

Tulsa rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Louisville, KY

Louisville rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Lexington, KY

Lexington rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Memphis, TN

Memphis rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Knoxville, TN

Knoxville rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Raleigh, NC

Raleigh rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Greensboro, NC

Greensboro rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Asheville, NC

Asheville rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Charleston, SC

Charleston rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Columbia, SC

Columbia rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Greenville, SC

Greenville rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Richmond, VA

Richmond rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Virginia Beach, VA

Virginia Beach rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Jacksonville, FL

Jacksonville rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Fort Myers, FL

Fort Myers rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Sarasota, FL

Sarasota rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in West Palm Beach, FL

West Palm Beach rates usually run above the national average, reflecting higher local labor and housing costs.

Age-in-Place Modifications in Pensacola, FL

Pensacola rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Birmingham, AL

Birmingham rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in New Orleans, LA

New Orleans rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Jackson, MS

Jackson rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Little Rock, AR

Little Rock rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Albuquerque, NM

Albuquerque rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Tucson, AZ

Tucson rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Salt Lake City, UT

Salt Lake City rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Boise, ID

Boise rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Colorado Springs, CO

Colorado Springs rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in El Paso, TX

El Paso rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Omaha, NE

Omaha rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Des Moines, IA

Des Moines rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Wichita, KS

Wichita rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Cleveland, OH

Cleveland rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Grand Rapids, MI

Grand Rapids rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Buffalo, NY

Buffalo rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Rochester, NY

Rochester rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Albany, NY

Albany rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Hartford, CT

Hartford rates usually run above the national average, reflecting higher local labor and housing costs.

Age-in-Place Modifications in Providence, RI

Providence rates usually run above the national average, reflecting higher local labor and housing costs.

Age-in-Place Modifications in Portland, ME

Portland rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Burlington, VT

Burlington rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Honolulu, HI

Honolulu rates usually run above the national average, reflecting higher local labor and housing costs.

Age-in-Place Modifications in Anchorage, AK

Anchorage rates usually run above the national average, reflecting higher local labor and housing costs.

Age-in-Place Modifications in Spokane, WA

Spokane rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Reno, NV

Reno rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Billings, MT

Billings rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Sioux Falls, SD

Sioux Falls rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Fargo, ND

Fargo rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in Madison, WI

Madison rates run close to the national average, with some neighborhoods slightly higher.

Age-in-Place Modifications in Charleston, WV

Charleston rates typically run below the national average, reflecting a lower local cost of living.

Age-in-Place Modifications in North Charleston, SC

North Charleston rates usually run slightly below the national average, and many Charleston area providers serve it without a travel surcharge.

Age-in-Place Modifications in Queens, NY

Queens rates typically run above the national average, reflecting New York area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Brooklyn, NY

Brooklyn rates typically run above the national average, reflecting New York area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Mount Pleasant, SC

Mount Pleasant pricing sits close to the national average, in line with the wider Charleston area.

Age-in-Place Modifications in West Columbia, SC

West Columbia rates usually run slightly below the national average, and many Columbia area providers serve it without a travel surcharge.

Age-in-Place Modifications in Scottsdale, AZ

Scottsdale pricing sits close to the national average, in line with the wider Phoenix area.

Age-in-Place Modifications in Brentwood, TN

Brentwood pricing sits close to the national average, in line with the wider Nashville area.

Age-in-Place Modifications in Tigard, OR

Tigard pricing sits close to the national average, in line with the wider Portland area.

Age-in-Place Modifications in Overland Park, KS

Overland Park rates usually run slightly below the national average, and many Kansas City area providers serve it without a travel surcharge.

Age-in-Place Modifications in Plano, TX

Plano pricing sits close to the national average, in line with the wider Dallas area.

Age-in-Place Modifications in Santa Clara, CA

Santa Clara rates typically run above the national average, reflecting San Jose area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Mesa, AZ

Mesa rates usually run slightly below the national average, and many Phoenix area providers serve it without a travel surcharge.

Age-in-Place Modifications in Beaverton, OR

Beaverton pricing sits close to the national average, in line with the wider Portland area.

Age-in-Place Modifications in Round Rock, TX

Round Rock pricing sits close to the national average, in line with the wider Austin area.

Age-in-Place Modifications in Cary, NC

Cary pricing sits close to the national average, in line with the wider Raleigh area.

Age-in-Place Modifications in Edmond, OK

Edmond rates usually run slightly below the national average, and many Oklahoma City area providers serve it without a travel surcharge.

Age-in-Place Modifications in Campbell, CA

Campbell rates typically run above the national average, reflecting San Jose area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Richardson, TX

Richardson pricing sits close to the national average, in line with the wider Dallas area.

Age-in-Place Modifications in Bartlett, TN

Bartlett rates usually run slightly below the national average, and many Memphis area providers serve it without a travel surcharge.

Age-in-Place Modifications in Silver Spring, MD

Silver Spring rates typically run above the national average, reflecting Washington area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Greer, SC

Greer rates usually run slightly below the national average, and many Greenville area providers serve it without a travel surcharge.

Age-in-Place Modifications in The Bronx, NY

The Bronx rates typically run above the national average, reflecting New York area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Aurora, CO

Aurora pricing sits close to the national average, in line with the wider Denver area.

Age-in-Place Modifications in Durham, NC

Durham pricing sits close to the national average, in line with the wider Raleigh area.

Age-in-Place Modifications in Centennial, CO

Centennial pricing sits close to the national average, in line with the wider Denver area.

Age-in-Place Modifications in Summerville, SC

Summerville rates usually run slightly below the national average, and many Charleston area providers serve it without a travel surcharge.

Age-in-Place Modifications in Chandler, AZ

Chandler pricing sits close to the national average, in line with the wider Phoenix area.

Age-in-Place Modifications in Irving, TX

Irving pricing sits close to the national average, in line with the wider Dallas area.

Age-in-Place Modifications in Nicholasville, KY

Nicholasville rates usually run slightly below the national average, and many Lexington area providers serve it without a travel surcharge.

Age-in-Place Modifications in Alexandria, VA

Alexandria rates typically run above the national average, reflecting Washington area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Fort Worth, TX

Fort Worth pricing sits close to the national average, in line with the wider Dallas area.

Age-in-Place Modifications in Beverly Hills, CA

Beverly Hills rates typically run above the national average, reflecting Los Angeles area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Tempe, AZ

Tempe pricing sits close to the national average, in line with the wider Phoenix area.

Age-in-Place Modifications in Kirkland, WA

Kirkland rates typically run above the national average, reflecting Seattle area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Carrollton, TX

Carrollton pricing sits close to the national average, in line with the wider Dallas area.

Age-in-Place Modifications in Spring, TX

Spring pricing sits close to the national average, in line with the wider Houston area.

Age-in-Place Modifications in North Las Vegas, NV

North Las Vegas rates usually run slightly below the national average, and many Las Vegas area providers serve it without a travel surcharge.

Age-in-Place Modifications in Glendale, AZ

Glendale rates usually run slightly below the national average, and many Phoenix area providers serve it without a travel surcharge.

Age-in-Place Modifications in Katy, TX

Katy pricing sits close to the national average, in line with the wider Houston area.

Age-in-Place Modifications in Arlington, VA

Arlington rates typically run above the national average, reflecting Washington area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Bethesda, MD

Bethesda rates typically run above the national average, reflecting Washington area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Glendale, CA

Glendale rates typically run above the national average, reflecting Los Angeles area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Bala Cynwyd, PA

Bala Cynwyd pricing sits close to the national average, in line with the wider Philadelphia area.

Age-in-Place Modifications in Waltham, MA

Waltham rates typically run above the national average, reflecting Boston area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Mauldin, SC

Mauldin rates usually run slightly below the national average, and many Greenville area providers serve it without a travel surcharge.

Age-in-Place Modifications in Cayce, SC

Cayce rates usually run slightly below the national average, and many Columbia area providers serve it without a travel surcharge.

Age-in-Place Modifications in Brookline, MA

Brookline rates typically run above the national average, reflecting Boston area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Kent, WA

Kent pricing sits close to the national average, in line with the wider Seattle area.

Age-in-Place Modifications in Hollywood, FL

Hollywood pricing sits close to the national average, in line with the wider Miami area.

Age-in-Place Modifications in Rockville, MD

Rockville rates typically run above the national average, reflecting Washington area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Greenwood, IN

Greenwood rates usually run slightly below the national average, and many Indianapolis area providers serve it without a travel surcharge.

Age-in-Place Modifications in Jenkintown, PA

Jenkintown pricing sits close to the national average, in line with the wider Philadelphia area.

Age-in-Place Modifications in Bellevue, WA

Bellevue rates typically run above the national average, reflecting Seattle area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Wauwatosa, WI

Wauwatosa pricing sits close to the national average, in line with the wider Milwaukee area.

Age-in-Place Modifications in Sterling Heights, MI

Sterling Heights rates usually run slightly below the national average, and many Detroit area providers serve it without a travel surcharge.

Age-in-Place Modifications in Hendersonville, NC

Hendersonville pricing sits close to the national average, in line with the wider Asheville area.

Age-in-Place Modifications in Everett, WA

Everett pricing sits close to the national average, in line with the wider Seattle area.

Age-in-Place Modifications in Salem, OR

Salem rates usually run slightly below the national average, and many Portland area providers serve it without a travel surcharge.

Age-in-Place Modifications in Englewood, CO

Englewood pricing sits close to the national average, in line with the wider Denver area.

Age-in-Place Modifications in Saint Paul, MN

Saint Paul pricing sits close to the national average, in line with the wider Minneapolis area.

Age-in-Place Modifications in Oakland, CA

Oakland rates typically run above the national average, reflecting San Francisco area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Arlington, TX

Arlington pricing sits close to the national average, in line with the wider Dallas area.

Age-in-Place Modifications in Anaheim, CA

Anaheim rates typically run above the national average, reflecting Los Angeles area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Irmo, SC

Irmo rates usually run slightly below the national average, and many Columbia area providers serve it without a travel surcharge.

Age-in-Place Modifications in Farmers Branch, TX

Farmers Branch pricing sits close to the national average, in line with the wider Dallas area.

Age-in-Place Modifications in Woburn, MA

Woburn rates typically run above the national average, reflecting Boston area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Lincolnwood, IL

Lincolnwood pricing sits close to the national average, in line with the wider Chicago area.

Age-in-Place Modifications in Milwaukie, OR

Milwaukie pricing sits close to the national average, in line with the wider Portland area.

Age-in-Place Modifications in Worthington, OH

Worthington pricing sits close to the national average, in line with the wider Columbus area.

Age-in-Place Modifications in Lake Oswego, OR

Lake Oswego rates typically run above the national average, reflecting Portland area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Broken Arrow, OK

Broken Arrow rates usually run slightly below the national average, and many Tulsa area providers serve it without a travel surcharge.

Age-in-Place Modifications in Toronto, ON

Toronto rates sit at the top of the Canadian range, and publicly funded hours through Ontario Health atHome are usually supplemented privately.

Age-in-Place Modifications in Ottawa, ON

Ottawa pricing runs modestly below Toronto, with bilingual English and French providers widely available.

Age-in-Place Modifications in Vancouver, BC

Metro Vancouver rates are comparable to Toronto, and ferry or bridge travel can add a surcharge outside the core.

Age-in-Place Modifications in Mississauga, ON

Mississauga rates are slightly below downtown Toronto, and many specialists serve the wider Peel Region.

Age-in-Place Modifications in Calgary, AB

Calgary rates run close to the Canadian midpoint, modestly below Toronto and Vancouver.

Age-in-Place Modifications in Edmonton, AB

Edmonton pricing runs below Calgary's, among the more affordable major Canadian metros.

Age-in-Place Modifications in Victoria, BC

Victoria rates run close to Vancouver's, among the higher end of the Canadian range.

Age-in-Place Modifications in Winnipeg, MB

Winnipeg is one of the more affordable major Canadian metros for in-home care.

Age-in-Place Modifications in Halifax, NS

Halifax pricing runs close to the Canadian midpoint.

Age-in-Place Modifications in Brampton, ON

Brampton rates run modestly below downtown Toronto, and many specialists serve the wider Peel Region.

Age-in-Place Modifications in Hamilton, ON

Hamilton pricing runs below Toronto's, among the more affordable markets in the Greater Toronto and Hamilton Area.

Age-in-Place Modifications in Burlington, ON

Burlington pricing sits between Hamilton and Oakville, and many specialists serve the wider Halton and Hamilton area.

Age-in-Place Modifications in Brantford, ON

Brantford pricing runs below Hamilton's, and many specialists also serve Brant County and Norfolk County.

Age-in-Place Modifications in Norfolk County, ON

Norfolk County is a largely rural market, so travel distance can affect pricing, and many specialists come from Hamilton and Brantford.

Age-in-Place Modifications in Kitchener, ON

Kitchener-Waterloo pricing runs below Toronto's, among the more affordable markets in southwestern Ontario.

Age-in-Place Modifications in London, ON

London pricing runs below Toronto's, among the more affordable markets in southwestern Ontario.

Age-in-Place Modifications in Montreal, QC

Montreal rates run below Toronto's and Vancouver's, among the more affordable major Canadian metros, with French and English service widely available.

Age-in-Place Modifications in Quebec City, QC

Quebec City pricing runs below Montreal's, among the more affordable major Canadian metros.

Age-in-Place Modifications in Vaughan, ON

Vaughan rates typically run above the Canadian average, reflecting Toronto area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in North Vancouver, BC

North Vancouver rates typically run above the Canadian average, reflecting Vancouver area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Burnaby, BC

Burnaby rates typically run above the Canadian average, reflecting Vancouver area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in North York, ON

North York rates typically run above the Canadian average, reflecting Toronto area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Dartmouth, NS

Dartmouth pricing sits close to the Canadian average, in line with the wider Halifax area.

Age-in-Place Modifications in Oakville, ON

Oakville rates typically run above the Canadian average, reflecting Toronto area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in East York, ON

East York rates typically run above the Canadian average, reflecting Toronto area living costs, and some providers set a two-hour minimum visit.

Age-in-Place Modifications in Markham, ON

Markham rates typically run above the Canadian average, reflecting Toronto area living costs, and some providers set a two-hour minimum visit.

Ranges are a planning guide gathered from provider listings and public rate information, not a quote. Confirm pricing directly with the provider before work begins.