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Maryland rates for HCPCS 96004

Phys/Qhp R&I Cptr Mtn Alys Walk/Funcjl Actv Repr

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.87 / $106.20 / $140.41
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.22 / $123.58 / $149.53
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.83 / $147.19 / $234.36
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$80.79 / $118.40 / $161.58
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$86.12 / $119.61 / $217.67
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.05 / $123.88 / $155.52