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Utah 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 $112 · 10th–90th $112–$1620%20%40%90th$112Professionalmedian $123 · 10th–90th $55–$2570%10%10th90th$123$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. Small sample — interpret with caution. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$112.20 / $112.20 / $162.18
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $125.89 / $239.88
Aetna
Facility/Professional
Professional
Modifier
25
Typical Low / Median / Typical High
$18.20 / $91.20 / $295.12
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $125.89 / $245.47
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $208.93
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $154.88 / $229.09
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $154.88 / $204.17
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$107.15 / $169.82 / $257.04
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$70.79 / $114.82 / $194.98