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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
$57.54 / $83.18 / $125.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $199.53 / $302.00
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$213.80 / $239.88 / $239.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$41.69 / $41.69 / $41.69