| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.20 | $125.20 | $125.20 | |
Aetna
| Professional | $55.00 | $87.43 | $125.20 | |
Cigna
| Professional | $118.80 | $118.80 | $118.80 |
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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $125.20 | $125.20 | $125.20 | |
Aetna
| Professional | $55.00 | $87.43 | $125.20 | |
Cigna
| Professional | $118.80 | $118.80 | $118.80 |