| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $54.28 | $54.28 | $731.48 | |
Medica
| Facility | $45.12 | $54.28 | $530.75 | |
Medica
| Professional | $67.18 | $104.44 | $3,407.99 | |
United
| Professional | $71.14 | $184.46 | $669.91 |
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; technical support and patient instructions, surveillance, analysis, and transmission of daily and emergent data reports as prescribed by a physician or other qualified health care professional
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $54.28 | $54.28 | $731.48 | |
Medica
| Facility | $45.12 | $54.28 | $530.75 | |
Medica
| Professional | $67.18 | $104.44 | $3,407.99 | |
United
| Professional | $71.14 | $184.46 | $669.91 |