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Montana rates for HCPCS 0464T

Visual evoked potential, testing for glaucoma, with interpretation and report

Facilitymedian $123 · 10th–90th $62–$1350%20%40%10th90th$123Professionalmedian $68 · 10th–90th $54–$1100%20%10th90th$68$50.0$100.0$200.0$500.0

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $67.61 / $79.43
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $134.90
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $95.50 / $112.20
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $446.68
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $123.03 / $446.68
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $66.07 / $112.20
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $95.50 / $112.20
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $114.82 / $131.83