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Montana 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 $166 · 10th–90th $105–$2630%20%10th90th$166Professionalmedian $145 · 10th–90th $76–$2510%10%20%10th90th$145$10.0$20.0$50.0$100.0$200.0$500.0

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
$74.13 / $144.54 / $251.19
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$91.20 / $177.83 / $251.19
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $144.54 / $234.42
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $131.83 / $234.42
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$158.49 / $204.17 / $263.03
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $204.17 / $263.03
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $114.82 / $208.93
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $144.54 / $234.42
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $177.83 / $275.42