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Michigan 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
$84.95 / $84.95 / $84.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.19 / $84.95 / $125.20
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $30.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.00 / $90.00 / $118.80
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.95 / $92.75 / $106.66
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.95 / $92.75 / $106.66
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $30.00 / $55.00
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