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Missouri 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
$106.97 / $112.71 / $132.65
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.87 / $112.71 / $132.65
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,423.00 / $1,466.00 / $1,641.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.00 / $129.11 / $194.38
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.81 / $154.77 / $246.59
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.73 / $136.81 / $259.94
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.97 / $166.36 / $686.29
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.54 / $144.31 / $250.99