go back

Kentucky rates for HCPCS 92004

Oph Svcs Medical Xm&Eval Compre New Pt 1/> Vst

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$101.45 / $101.45 / $157.27
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.90 / $132.13 / $185.94
Aetna
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$133.31 / $143.93 / $341.58
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.51 / $132.66 / $185.74
Ambetter
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$106.98 / $106.98 / $199.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.75 / $86.47 / $174.88
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.58 / $94.14 / $124.09
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.68 / $135.63 / $189.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.77 / $149.77 / $149.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.08 / $123.68 / $221.51
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $94.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.80 / $122.13 / $194.48