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Pennsylvania rates for HCPCS 99458

Remote physiologic monitoring treatment management services, clinical staff/physician/other qualified health care professional time in a calendar month requiring 1 real-time interactive communication with the patient/caregiver during the calendar month; each additional 20 minutes (List separately in addition to code for primary procedure)

Facilitymedian $38 · 10th–90th $24–$650%20%10th90th$38Professionalmedian $41 · 10th–90th $25–$910%10%20%10th90th$41$10.0$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $30.90 / $64.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $39.81 / $102.33
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$41.69 / $41.69 / $41.69
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $39.81 / $47.86
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $41.69
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,511.38 / $8,511.38 / $77,624.71
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$34.67 / $40.74 / $67.61
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $45.71 / $45.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $43.65 / $69.18
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$58.88 / $58.88 / $58.88
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$48.98 / $63.10 / $85.11
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $44.67 / $74.13
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$38.02 / $40.74 / $54.95
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $41.69
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$23.99 / $23.99 / $30.90
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $33.11 / $63.10
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50.12 / $50.12 / $50.12
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $61.66 / $102.33
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$35.48 / $44.67 / $46.77
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $30.90 / $51.29
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$48.98 / $48.98 / $48.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $40.74 / $67.61