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Maryland 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
Professional
Modifier
Low / Median / High Price
$58.78 / $84.95 / $125.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.80 / $118.80 / $288.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.00 / $233.00 / $238.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$42.08 / $42.08 / $42.08
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.00 / $90.00 / $90.00