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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
$398.11 / $398.11 / $398.11
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $87.10 / $398.11
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$489.78 / $489.78 / $489.78
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.20 / $44.67 / $54.95
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$33.88 / $43.65 / $57.54
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $43.65 / $48.98
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $151.36 / $151.36