| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Professional | $178.29 | $214.17 | $673.87 | |
Medica
| Facility | $151.55 | $178.29 | $249.61 | |
Medica
| Professional | $63.23 | $76.84 | $643.53 | |
United
| Professional | $63.23 | $74.43 | $97.93 |
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 | $178.29 | $214.17 | $673.87 | |
Medica
| Facility | $151.55 | $178.29 | $249.61 | |
Medica
| Professional | $63.23 | $76.84 | $643.53 | |
United
| Professional | $63.23 | $74.43 | $97.93 |