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Nebraska 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
$101.91 / $101.91 / $101.91
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.43 / $104.04 / $115.70
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,479.07 / $1,913.91 / $3,000.14
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.91 / $164.12 / $229.34
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.68 / $233.44 / $283.58
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.91 / $172.23 / $274.99
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.74 / $218.42 / $686.29
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$166.26 / $233.44 / $292.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.00 / $224.75 / $292.72
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$179.83 / $211.42 / $421.22
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.97 / $242.45 / $267.89