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Michigan rates for HCPCS 92083

Visual field examination, unilateral or bilateral, with interpretation and report; extended examination (eg, Goldmann visual fields with at least 3 isopters plotted and static determination within the central 30 degrees or quantitative, automated threshold perimetry, Octopus program G-1, 32 or 42, Humphrey visual field analyzer full threshold programs 30-2, 24-2, or 30/60-2)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.84 / $70.84 / $118.75
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.27 / $26.28 / $42.94
Aetna
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$22.70 / $29.19 / $37.54
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$26.56 / $39.43 / $60.08
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.30 / $61.03 / $85.95
Ambetter
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$34.71 / $34.71 / $34.71
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.34 / $54.78 / $94.12
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$39.34 / $75.30 / $117.65
BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$42.08 / $42.08 / $42.08
BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$58.59 / $58.59 / $58.59
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.57 / $39.19 / $74.37
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$24.76 / $40.59 / $74.37
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.04 / $58.65 / $119.78
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.96 / $25.12 / $49.81
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$26.78 / $33.79 / $65.72
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.47 / $74.39 / $103.75
Health Alliance Plan
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$18.76 / $28.12 / $38.50
Health Alliance Plan
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$23.92 / $35.43 / $35.43
Health Alliance Plan
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$31.34 / $39.71 / $60.07
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.70 / $45.87 / $80.21
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.47 / $71.47 / $98.08
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.67 / $28.70 / $38.22
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$31.94 / $39.69 / $56.78