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South Dakota 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 $115 · 10th–90th $107–$1950%50%10th90th$115Professionalmedian $141 · 10th–90th $100–$2510%20%10th90th$141$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $114.82 / $114.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $112.20 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $223.87 / $275.42
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $275.42
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $151.36 / $691.83
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $263.03
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $223.87 / $263.03
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $173.78 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $194.98 / $288.40
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $251.19 / $257.04