go back

Arizona rates for HCPCS 99455

Work related or medical disability examination by the treating physician that includes: Completion of a medical history commensurate with the patient's condition; Performance of an examination commensurate with the patient's condition; Formulation of a diagnosis, assessment of capabilities and stability, and calculation of impairment; Development of future medical treatment plan; and Completion of necessary documentation/certificates and report.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.19 / $84.19 / $84.19
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$60.04 / $84.95 / $125.20
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.00 / $27.00 / $27.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.14 / $53.64 / $70.09
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.00 / $202.00 / $211.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.56 / $84.95 / $144.81
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$451.00 / $451.00 / $451.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$233.00 / $233.00 / $233.00