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Minnesota rates for HCPCS 92540

Basic vestibular evaluation, includes spontaneous nystagmus test with eccentric gaze fixation nystagmus, with recording, positional nystagmus test, minimum of 4 positions, with recording, optokinetic nystagmus test, bidirectional foveal and peripheral stimulation, with recording, and oscillating tracking test, with recording

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$83.18 / $83.18 / $83.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $107.15 / $131.83
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$63.10 / $75.86 / $93.33
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$19.05 / $30.20 / $38.02
BCBS
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$69.18 / $69.18 / $69.18
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $251.19 / $363.08
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$107.15 / $181.97 / $263.03
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$41.69 / $72.44 / $100.00
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$177.83 / $251.19 / $288.40
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $245.47 / $416.87
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$75.86 / $177.83 / $302.00
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$26.30 / $69.18 / $114.82
Health Partners
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$177.83 / $223.87 / $467.74
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $263.03 / $354.81
Health Partners
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$114.82 / $190.55 / $257.04
Health Partners
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$41.69 / $74.13 / $100.00
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$346.74 / $346.74 / $346.74
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $181.97 / $407.38
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.79 / $125.89 / $295.12
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$20.42 / $39.81 / $104.71
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.33 / $154.88 / $302.00
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$70.79 / $117.49 / $223.87
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$23.44 / $39.81 / $81.28