| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $23.90 | $29.12 | $192.00 | |
Molina
| Professional | $33.19 | $38.65 | $85.00 | |
Providence
| Facility | $20.14 | $28.82 | $47.23 | |
United
| Professional | $25.70 | $42.72 | $61.41 |
Visual field assessment, with concurrent real time data analysis and accessible data storage with patient initiated data transmitted to a remote surveillance center for up to 30 days; review and interpretation with report by a physician or other qualified health care professional
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $23.90 | $29.12 | $192.00 | |
Molina
| Professional | $33.19 | $38.65 | $85.00 | |
Providence
| Facility | $20.14 | $28.82 | $47.23 | |
United
| Professional | $25.70 | $42.72 | $61.41 |