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New York rates for HCPCS G2004

Comprehensive (60 minutes) in-home visit for a new patient postdischarge. For use only in a Medicare-approved CMMI model. (Services must be furnished within a beneficiary's home, domiciliary, rest home, assisted living and/or nursing facility within 90 days following discharge from an inpatient facility and no more than nine times.)

Facilitymedian $174 · 10th–90th $132–$2750%50%10th90th$174Professionalmedian $155 · 10th–90th $135–$2190%20%40%10th90th$155$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

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
$134.90 / $158.49 / $190.55
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $147.91 / $190.55
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $165.96 / $302.00
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$251.19 / $251.19 / $251.19
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $53,703.18
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $223.87
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$173.78 / $275.42 / $676.08
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $269.15 / $354.81
Excellus BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $151.36 / $151.36
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $173.78 / $281.84
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$50,118.72 / $53,703.18 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $234.42 / $263.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$489.78 / $588.84 / $794.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $204.17 / $398.11
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$131.83 / $173.78 / $173.78
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $173.78 / $295.12