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Maine rates for HCPCS 92004

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.05 / $152.03 / $237.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.17 / $129.13 / $176.13
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.09 / $152.65 / $287.18
Community Health Options
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.66 / $193.01 / $299.58
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.33 / $138.46 / $242.53
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.35 / $168.96 / $236.79
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.37 / $173.26 / $266.33