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Arizona rates for HCPCS 0704T

Remote treatment of amblyopia using an eye tracking device; device supply with initial set-up and patient education on use of equipment

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$251.00 / $251.00 / $251.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9.72 / $37.79 / $59.88
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$15.33 / $18.30 / $19.68
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.00 / $276.10 / $358.93