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Missouri 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
$142.72 / $142.72 / $142.72
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$84.19 / $84.95 / $119.78
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$40.50 / $40.50 / $275.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1.14 / $45.00 / $90.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$246.71 / $246.71 / $246.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.95 / $92.35 / $175.85
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$451.00 / $451.00 / $451.00
Qualchoice
Facility/Professional
Professional
Modifier
Low / Median / High Price
$31.05 / $31.05 / $31.05
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