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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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7.08 / $7.08 / $7.08
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.08 / $7.94 / $10.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.55 / $9.55 / $9.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13.49 / $13.49 / $13.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.76 / $7.76 / $7.76
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8.13 / $11.75 / $19.50
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7.59 / $11.22 / $18.62
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $33.11
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12.88 / $16.98 / $17.38
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$11.75 / $11.75 / $11.75
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$11.75 / $15.49 / $25.12
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$10.47 / $14.79 / $21.88
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$8.91 / $13.18 / $21.38
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$9.12 / $9.77 / $17.38