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Virginia 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
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$38.57 / $49.55 / $68.16
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,420.00 / $9,929.00 / $10,945.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$7,420.00 / $9,929.00 / $10,945.00