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Illinois 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 $8 · 10th–90th $8–$90%50%10th90th$8Professionalmedian $9 · 10th–90th $7–$140%20%40%10th90th$9$0.1$0.5$2.0$10.0$50.0$200.0

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
$7.76 / $8.32 / $8.91
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
$38.02 / $38.02 / $38.02
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.55 / $12.30 / $12.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $9.33
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $14.45 / $21.88
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $10.72 / $11.48
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $8.32
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $12.59 / $19.50