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Washington 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 $13 · 10th–90th $8–$200%10%10th90th$13Professionalmedian $9 · 10th–90th $7–$200%10%20%10th90th$9$10.0$20.0$50.0$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
$7.08 / $7.08 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6.03 / $7.94 / $10.00
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $15.49 / $22.39
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
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8.13 / $11.75 / $20.42
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$7.59 / $11.48 / $19.50
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $33.11
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12.59 / $16.98 / $17.38
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$11.75 / $11.75 / $11.75
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11.75 / $14.79 / $24.55
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$10.72 / $15.49 / $21.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5.75 / $5.75 / $6.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.33 / $13.49 / $22.39
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$9.12 / $9.77 / $18.62