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New York 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 $135 · 10th–90th $72–$1510%50%10th90th$135Professionalmedian $151 · 10th–90th $71–$3240%10%10th90th$151$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $151.36 / $338.84
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$131.83 / $169.82 / $338.84
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$141.25 / $162.18 / $186.21
Ambetter
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$144.54 / $144.54 / $144.54
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $138.04 / $380.19
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $134.90
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $134.90 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $158.49 / $338.84
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$58.88 / $75.86 / $229.09
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $151.36 / $309.03
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $151.36 / $251.19
Highmark BCBS
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$138.04 / $151.36 / $151.36
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $208.93 / $398.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$21.38 / $70.79 / $181.97
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $134.90 / $257.04