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California 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 $12 · 10th–90th $8–$160%10%20%10th90th$12Professionalmedian $9 · 10th–90th $7–$230%10%20%10th90th$9$5.0$10.0$20.0$50.0$100.0$200.0$500.0

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
$7.08 / $52.48 / $52.48
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $7.94 / $25.12
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $10.23 / $13.18
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.00 / $12.30 / $13.80
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $11.75 / $20.89
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $11.48 / $22.39
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $8.32
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.71 / $10.47 / $13.80
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $9.33 / $15.85
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $85.11
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $70.79 / $70.79
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $10.23 / $15.49
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $23.44
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$29.51 / $29.51 / $29.51
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.12 / $9.12 / $9.12
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $10.00 / $18.62