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Virginia 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
$58.78 / $58.78 / $84.95
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.78 / $84.95 / $125.20
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.36 / $78.20 / $115.01
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$202.00 / $202.00 / $302.39
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$215.00 / $238.00 / $238.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$58.78 / $84.95 / $127.43
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$303.00 / $340.00 / $361.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$274.68 / $335.01 / $446.36
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$274.68 / $335.01 / $446.36
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$320.00 / $320.00 / $320.00