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Wisconsin 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 $126 · 10th–90th $102–$3720%20%10th90th$126Professionalmedian $117 · 10th–90th $93–$3310%10%20%10th90th$117$50.0$100.0$200.0$500.0$1.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$114.82 / $114.82 / $389.05
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $112.20 / $158.49
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $165.96 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$281.84 / $323.59 / $524.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $275.42 / $380.19
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $117.49 / $213.80
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $218.78 / $295.12
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $117.49 / $213.80
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $213.80 / $691.83
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$165.96 / $165.96 / $223.87
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $162.18 / $275.42
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $245.47 / $346.74
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $691.83 / $691.83
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $549.54 / $691.83
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $363.08 / $549.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $190.55 / $380.19