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Iowa 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
$94.92 / $105.98 / $149.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $251.40 / $283.43
Hally Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.63 / $155.82 / $365.63
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$117.00 / $212.93 / $283.43
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.78 / $252.13 / $686.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$153.00 / $251.40 / $283.43
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.71 / $233.44 / $283.43
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$134.40 / $134.40 / $290.39
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.62 / $204.79 / $299.47
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$167.09 / $211.50 / $248.80