go back

Massachusetts rates for HCPCS 0472T

Device evaluation, interrogation, and initial programming of intraocular retinal electrode array (eg, retinal prosthesis), in person, with iterative adjustment of the implantable device to test functionality, select optimal permanent programmed values with analysis, including visual training, with review and report by a qualified health care professional

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.51 / $54.51 / $54.51
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.87 / $57.77 / $104.34
AllWays Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.00 / $332.55 / $332.55
AllWays Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.15 / $192.11 / $1,033.75
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$424.87 / $502.47 / $654.47
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$309.77 / $531.41 / $710.02
Fallon Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$64.67 / $100.37 / $8,090.00
Fallon Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.06 / $86.98 / $117.76
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$78.64 / $158.38 / $650.54
Mass General Brigham
Facility/Professional
Facility
Modifier
Low / Median / High Price
$133.00 / $332.55 / $332.55
Mass General Brigham
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.15 / $188.22 / $1,033.75
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.15 / $159.41 / $311.35