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Indiana rates for HCPCS G0467

Federally Qualified Health Center (FQHC) visit, established patient; a medically-necessary, face-to-face encounter (one-on-one) between an established patient and a FQHC practitioner during which time one or more FQHC services are rendered and includes a typical bundle of Medicare-covered services that would be furnished per diem to a patient receiving a FQHC visit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$69.13 / $96.10 / $143.29
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$69.12 / $96.10 / $98.73
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$46.50 / $75.00 / $75.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.05 / $0.05
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$244.22 / $253.26 / $316.58
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.95 / $293.06 / $366.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$20.93 / $20.93 / $20.93