go back

Utah rates for HCPCS 96112

Developmental test administration (including assessment of fine and/or gross motor, language, cognitive level, social, memory and/or executive functions by standardized developmental instruments when performed), by physician or other qualified health care professional, with interpretation and report; first hour

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$151.36 / $151.36 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.00 / $128.82 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$109.65 / $169.82 / $229.09
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $60.26
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$125.89 / $162.18 / $204.17
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.23 / $173.78 / $218.78
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $173.78 / $263.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $138.04 / $208.93