go back

Wisconsin 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
Facility
Modifier
Low / Median / High Price
$66.07 / $66.07 / $66.07
Aetna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$28.84 / $28.84 / $28.84
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.48 / $74.13 / $245.47
Aetna
Facility/Professional
Professional
Modifier
25
Low / Median / High Price
$81.28 / $81.28 / $81.28
Aetna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$19.95 / $26.92 / $186.21
Aetna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$25.70 / $33.88 / $66.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $120.23 / $213.80
Anthem BCBS
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$27.54 / $52.48 / $93.33
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$102.33 / $181.97 / $323.59
Anthem BCBS
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$36.31 / $69.18 / $123.03
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$25.70 / $33.88 / $58.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$173.78 / $204.17 / $281.84
Cigna
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$70.79 / $83.18 / $114.82
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.57 / $128.82 / $162.18
Cigna
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$25.12 / $54.95 / $67.61
Cigna
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$37.15 / $75.86 / $95.50
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $70.79 / $125.89
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $131.83 / $177.83
DeanCare
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$38.02 / $56.23 / $74.13
DeanCare
Facility/Professional
Professional
Modifier
52
Low / Median / High Price
$89.13 / $131.83 / $177.83
DeanCare
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$51.29 / $77.62 / $102.33
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.12 / $70.79 / $131.83
Medica
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$61.66 / $151.36 / $151.36
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.66 / $93.33 / $309.03
Medica
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$24.55 / $34.67 / $165.96
Medica
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$32.36 / $48.98 / $257.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.79 / $141.25 / $204.17
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$147.91 / $398.11 / $398.11
Quartz
Facility/Professional
Facility
Modifier
26
Low / Median / High Price
$100.00 / $165.96 / $165.96
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$54.95 / $309.03 / $407.38
Quartz
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.44 / $138.04 / $165.96
Quartz
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$31.62 / $194.98 / $263.03
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$102.33 / $223.87 / $223.87
Security Health
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$43.65 / $79.43 / $89.13
Security Health
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$20.89 / $54.95 / $89.13
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.54 / $77.62 / $147.91
United
Facility/Professional
Professional
Modifier
26
Low / Median / High Price
$23.99 / $32.36 / $63.10
United
Facility/Professional
Professional
Modifier
TC
Low / Median / High Price
$32.36 / $44.67 / $85.11