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Oregon 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
$241.01 / $241.01 / $264.87
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.87 / $115.09 / $272.82
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$122.50 / $122.50 / $122.50
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$143.74 / $224.11 / $313.70
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.89 / $241.48 / $271.88
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$106.20 / $192.24 / $282.24
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.19 / $202.40 / $326.33
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$160.72 / $207.75 / $223.11
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.58 / $198.53 / $278.88
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$146.77 / $232.31 / $295.64
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.34 / $216.55 / $304.14
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.38 / $236.20 / $338.34