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West Virginia rates for HCPCS 92004

Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$371.54 / $371.54 / $436.52
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$77.62 / $125.89 / $251.19
Aetna
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$138.04 / $138.04 / $138.04
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$93.33 / $97.72 / $151.36
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.83 / $141.25 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.13 / $117.49 / $229.09
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $123.03 / $131.83
Highmark BCBS
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$117.49 / $128.82 / $128.82
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $104.71 / $186.21