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Indiana 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
$60.04 / $84.95 / $84.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.19 / $84.95 / $84.95
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.00 / $40.00 / $40.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.50 / $90.00 / $124.20
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$28,874.72 / $39,374.61 / $44,999.55
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34,124.66 / $34,124.66 / $36,749.62
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.98 / $118.80 / $202.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$233.00 / $233.00 / $233.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.00 / $320.00 / $320.00