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North Carolina 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 $10 · 10th–90th $8–$170%10%20%10th90th$10Professionalmedian $9 · 10th–90th $7–$300%10%20%10th90th$9$0.1$0.5$2.0$10.0$50.0

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
$7.94 / $7.94 / $13.49
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $7.94 / $10.00
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $10.23 / $13.18
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.41 / $10.96 / $30.20
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13.49 / $13.49 / $13.49
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.32 / $8.32 / $8.32
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.59 / $9.77 / $16.22
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.76 / $7.76 / $22.39
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.94 / $14.13 / $19.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10.23 / $10.23 / $10.23
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $10.23 / $16.98
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $75.86 / $85.11
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $54.95 / $70.79