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Utah rates for HCPCS 99456

Work related or medical disability examination by other than 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
$400.00 / $400.00 / $400.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.57 / $125.82 / $755.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$486.00 / $486.00 / $486.00
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.00 / $45.00 / $60.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.72 / $44.13 / $57.51