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Alaska rates for HCPCS 92004

Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.08 / $205.56 / $409.32
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.00 / $82.35 / $133.87
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$115.97 / $181.79 / $329.83
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$191.95 / $307.39 / $442.00
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$150.75 / $304.70 / $552.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$80.63 / $205.56 / $491.18
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$116.00 / $239.70 / $482.90
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$119.28 / $342.74 / $389.88