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Montana 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

Facilitymedian $186 · 10th–90th $115–$2000%50%10th90th$186Professionalmedian $115 · 10th–90th $93–$2450%10%10th90th$115$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $114.82 / $245.47
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $165.96 / $165.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $199.53
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $151.36 / $446.68
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $186.21 / $199.53
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $186.21 / $199.53
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $141.25 / $213.80
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $173.78 / $288.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $123.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $186.21 / $218.78