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Nationwide rates for HCPCS G0454

Physician documentation of face-to-face visit for durable medical equipment determination performed by nurse practitioner, physician assistant or clinical nurse specialist

Facilitymedian $11 · 10th–90th $8$180%20%40%10th90th$11Professionalmedian $9 · 10th–90th $7$180%50%10th90th$9$0.1$1.0$10.0$100.0$1.0K$10.0K$100.0K

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
$6.03 / $7.94 / $11.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $7.94 / $10.00
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $12.30 / $13.80
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $9.12 / $15.85
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $31.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $11.22
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6.17 / $8.32 / $11.75
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $11.22 / $22.39