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New York 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 $9 · 10th–90th $5$100%10%20%10th90th$9Professionalmedian $9 · 10th–90th $7$230%10%20%10th90th$9$0.2$1.0$5.0$20.0$100.0

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
$5.01 / $8.71 / $10.47
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $7.94 / $10.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.92 / $8.13 / $14.13
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $12.59
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$12.59 / $12.59 / $12.59
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 / $12.88
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3.98 / $3.98 / $16.22
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.00 / $12.88 / $19.05
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $8.13 / $9.77
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $9.55 / $19.05
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.47 / $12.88 / $19.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9.33 / $9.33 / $9.77
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$8.51 / $13.49 / $32.36
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7.76 / $9.55 / $9.55
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.24 / $9.12 / $15.85