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West Virginia rates for HCPCS 92004

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$108.60 / $367.54 / $440.86
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.00 / $102.97 / $156.94
Aetna
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$114.88 / $114.88 / $114.88
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$85.69 / $95.40 / $128.54
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.97 / $145.18 / $306.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$149.77 / $149.77 / $149.77
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.73 / $119.93 / $224.59
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.03 / $122.51 / $131.52
Highmark BCBS
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$116.25 / $116.50 / $137.03
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$98.62 / $125.41 / $194.45