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Pennsylvania rates for HCPCS 92201

Ophthalmoscopy, extended; with retinal drawing and scleral depression of peripheral retinal disease (eg, for retinal tear, retinal detachment, retinal tumor) with interpretation and report, unilateral or bilateral

Facilitymedian $138 · 10th–90th $74–$1700%20%10th90th$138Professionalmedian $25 · 10th–90th $18–$450%10%20%10th90th$25$10.0$20.0$50.0$100.0

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
$74.13 / $138.04 / $169.82
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $25.12 / $51.29
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$107.15 / $107.15 / $107.15
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$22.91 / $22.91 / $22.91
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $27.54
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$24.55 / $25.70 / $46.77
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$36.31 / $36.31 / $36.31
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $26.92 / $42.66
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.20 / $30.20 / $41.69
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$23.99 / $26.92 / $41.69
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $30.20 / $30.20
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$25.12 / $25.12 / $30.90
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$18.20 / $23.44 / $35.48
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $28.18 / $35.48
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$16.98 / $22.91 / $28.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$15.14 / $23.44 / $38.90