go back

Arizona rates for HCPCS 96004

Review and interpretation by physician or other qualified health care professional of comprehensive computer-based motion analysis, dynamic plantar pressure measurements, dynamic surface electromyography during walking or other functional activities, and dynamic fine wire electromyography, with written report

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.30 / $104.76 / $140.41
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$112.27 / $443.47 / $734.54
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.28 / $96.37 / $120.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.50 / $122.50 / $122.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.62 / $141.88 / $275.55
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$97.04 / $116.45 / $220.49
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.41 / $123.21 / $686.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.83 / $116.20 / $219.81