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Tennessee 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
Professional
Modifier
Low / Median / High Price
$99.48 / $111.40 / $140.52
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$71.91 / $79.18 / $101.50
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$21.06 / $30.31 / $38.04
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.01 / $143.57 / $175.39
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$105.92 / $105.92 / $105.92
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.63 / $97.52 / $147.07
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$50.20 / $76.62 / $116.25
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$15.10 / $24.05 / $38.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.27 / $127.92 / $326.22
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$68.18 / $95.49 / $235.39
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$19.54 / $29.05 / $90.83
Lucent Health
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$136.99 / $343.65 / $379.86
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$702.18 / $702.18 / $855.00
Lucent Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$487.97 / $487.97 / $607.73
Lucent Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$214.27 / $214.27 / $247.28
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$81.36 / $98.69 / $153.43
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$61.17 / $75.84 / $127.40
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$16.13 / $23.36 / $39.75