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Physician Documentation of DME Face-to-Face Visit

Kentucky 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

Rates data updated July 2026.

How much does Physician Documentation of DME Face-to-Face Visit cost?

$8.51

Typical negotiated rate. In Kentucky, July 2026.

Insurers have agreed to pay about $8.51 for this service. The price depends on where it is billed: about $8.51 from a physician practice, and about $10.72 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$8.51$8.32 to $8.91
FacilityA hospital or hospital-owned outpatient department$10.72$8.91 to $10.72

How much rates vary

Facilitymedian $11 · 10th to 90th $9 to $11Professionalmedian $9 · 10th to 90th $7 to $10
$10$20facility $11professional $9

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$8.32
Median
$8.91
Typical High
$8.91
Aetna
Setting
Professional
Modifier
Global
Typical Low
$6.17
Median
$8.32
Typical High
$9.77
Ambetter
Setting
Professional
Modifier
Global
Typical Low
$7.41
Median
$9.33
Typical High
$13.18
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$8.51
Median
$8.51
Typical High
$8.91
Cigna
Setting
Facility
Modifier
Global
Typical Low
$10.72
Median
$10.72
Typical High
$10.72
Cigna
Setting
Professional
Modifier
Global
Typical Low
$8.32
Median
$8.32
Typical High
$43.65
Molina
Setting
Professional
Modifier
Global
Typical Low
$32.36
Median
$32.36
Typical High
$33.11
United
Setting
Facility
Modifier
Global
Typical Low
$11.75
Median
$11.75
Typical High
$11.75
United
Setting
Professional
Modifier
Global
Typical Low
$7.76
Median
$9.55
Typical High
$16.98

Where Kentucky sits

The same service costs 2.0 times more in Minnesota than in Louisiana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Kentucky· 41st of 51

$8.51

MN $15.85LA $7.94

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.