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Oklahoma 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
$63.27 / $100.65 / $140.71
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
$124.34 / $133.69 / $176.52
Ambetter
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$124.34 / $124.34 / $133.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.75 / $142.10 / $195.12
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$65.00 / $111.62 / $192.17
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$81.81 / $119.73 / $176.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.13 / $142.16 / $592.72
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$88.74 / $129.76 / $163.49