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Work or Disability Evaluation Exam

Nationwide rates for HCPCS 99456

A detailed examination and written report on how an injury or illness affects a person's ability to work, carried out by a doctor who is not the patient's usual treating doctor. It covers the history, an examination, a diagnosis, an opinion on what the person can and cannot do, and completion of the required forms and reports.

Rates data updated July 2026.

How much does Work or Disability Evaluation Exam cost?

$87.10

Typical negotiated rate. Nationwide, July 2026.

Insurers have agreed to pay about $87.10 for this service. The price depends on where it is billed: about $87.10 from a physician practice, and about $151 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 50 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$87.10$87.10 to $302
FacilityA hospital or hospital-owned outpatient department$151$87.10 to $331

How much rates vary

Facilitymedian $151 · 10th to 90th $87 to $646Professionalmedian $87 · 10th to 90th $79 to $759
$0.1$1.0$10.0$100.0$1.0K$10.0K$100.0Kfacility $151professional $87

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$398.11
Aetna
Setting
Professional
Modifier
Global
Typical Low
$87.10
Median
$87.10
Typical High
$398.11
BCBS
Setting
Facility
Modifier
Global
Typical Low
$158.49
Median
$194.98
Typical High
$218.78
BCBS
Setting
Professional
Modifier
Global
Typical Low
$43.65
Median
$79.43
Typical High
$181.97
Cigna
Setting
Facility
Modifier
Global
Typical Low
$151.36
Median
$151.36
Typical High
$151.36
Cigna
Setting
Professional
Modifier
Global
Typical Low
$104.71
Median
$275.42
Typical High
$512.86
United
Setting
Facility
Modifier
Global
Typical Low
$44.67
Median
$288.40
Typical High
$549.54
United
Setting
Professional
Modifier
Global
Typical Low
$60.26
Median
$173.78
Typical High
$204.17

What it costs in each state

The same service costs 30.9 times more in Minnesota than in North Carolina. Every bar is a state, most expensive first. Pick one to see its carriers and full range.

MN $2,512NC $81.28

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.