go back

Vermont 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
$122.35 / $122.35 / $122.35
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.11 / $122.35 / $122.35
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$94.28 / $156.49 / $388.81
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.32 / $160.56 / $255.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.50 / $160.27 / $465.92