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California rates for HCPCS 92004

Ophthalmological services: medical examination and evaluation with initiation of diagnostic and treatment program; comprehensive, new patient, 1 or more visits

Facilitymedian $117 · 10th–90th $79$2340%10%20%10th90th$117Professionalmedian $162 · 10th–90th $91$3890%10%10th90th$162$10.0$20.0$50.0$100.0$200.0$500.0$1.0K

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
$91.20 / $162.18 / $407.38
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$131.83 / $169.82 / $346.74
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $144.54 / $354.81
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$120.23 / $141.25 / $213.80
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $97.72 / $97.72
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $147.91 / $436.52
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$239.88 / $239.88 / $239.88
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $123.03 / $316.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $144.54 / $288.40
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $97.72 / $229.09
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $151.36 / $257.04
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $588.84
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$165.96 / $954.99 / $1,202.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $208.93 / $724.44
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $234.42
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$89.13 / $151.36 / $316.23
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $323.59 / $501.19
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $100.00 / $213.80
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $102.33 / $102.33
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $109.65 / $218.78
United
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$64.57 / $64.57 / $64.57