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South Dakota 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 $42$2190%20%10th90th$135Professionalmedian $141 · 10th–90th $63$2290%20%10th90th$141$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
Facility
Modifier
Typical Low / Median / Typical High
$41.69 / $41.69 / $134.90
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$63.10 / $141.25 / $229.09
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$91.20 / $177.83 / $331.13
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $213.80 / $239.88
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $194.98 / $331.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $141.25 / $257.04
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $190.55 / $389.05
Medica
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$223.87 / $275.42 / $302.00
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $295.12 / $363.08
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$131.83 / $181.97 / $288.40
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $72.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $128.82 / $251.19
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $208.93 / $331.13