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North Carolina 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
$257.00 / $257.00 / $257.00
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$75.00 / $75.00 / $100.00
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.00 / $251.00 / $251.00