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North Carolina 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
$37.49 / $123.00 / $183.41
Aetna
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$80.00 / $218.26 / $387.83
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$126.86 / $138.33 / $251.27
Ambetter
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$135.53 / $139.55 / $186.51
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.00 / $61.00 / $61.18
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.77 / $149.77 / $149.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.00 / $123.15 / $269.19
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.30 / $132.00 / $204.00
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.00 / $183.00 / $183.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.03 / $163.69 / $212.99
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.72 / $122.13 / $168.20
Wellcare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$460.75 / $460.75 / $460.75
Wellcare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$592.72 / $944.28 / $1,210.43