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Indiana rates for HCPCS G0469

Federally Qualified Health Center (FQHC) visit, mental health, new patient; a medically-necessary, face-to-face mental health encounter (one-on-one) between a new 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 mental health visit

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.26 / $142.26 / $142.26
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.15 / $142.26 / $142.26
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.75 / $62.75 / $91.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$0.02 / $0.02 / $0.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$327.63 / $327.63 / $424.71
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$254.82 / $376.78 / $442.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.00 / $66.00 / $66.00