go back

Minnesota 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
Facility
Modifier
Low / Median / High Price
$116.02 / $116.02 / $116.02
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.87 / $116.02 / $149.08
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$176.28 / $379.00 / $935.43
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.80 / $280.91 / $374.22
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$261.10 / $370.27 / $890.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$176.20 / $284.57 / $443.13
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$237.24 / $338.52 / $701.38
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.45 / $264.88 / $400.40
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$114.20 / $171.99 / $273.95
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.62 / $241.01 / $686.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.68 / $237.62 / $430.13