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New Hampshire 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
$91.27 / $120.19 / $170.98
Aetna
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$114.88 / $114.88 / $114.88
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$450.00 / $450.00 / $450.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.15 / $100.20 / $155.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.00 / $133.87 / $332.29
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.20 / $192.41 / $371.31
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$100.36 / $195.26 / $367.56
Well Sense
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.59 / $105.83 / $165.07