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South Dakota 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 / $84.95
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$84.95 / $143.57 / $211.59
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.91 / $154.91 / $345.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$233.00 / $233.00 / $233.00
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.00 / $153.00 / $153.00