CPT 0704T
Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.
Original text from hospital filings
Rem tx amblyopia setup&edu
Low
$0
Average
$136
Median
$106
High
$453
Each payer's average rate across its hospitals, under the methodology and billing class chosen below.
12 payers; the 90th percentile is 4.1× the 10th. Each bar is a price range and its height is how many payers fall in it. Hover a bar, or a row in the ladder, for details.
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| # | ||||||||
|---|---|---|---|---|---|---|---|---|
| 1 | Blue Cross Blue Shield fee schedule · outpatient · +3 other terms | 89 | $181 | $193 | $79 | 41% | — | $0 – $381 |
| 2 | Bcbs Tx fee schedule · outpatient | 30 | $219 | $201 | $74 | 37% | — | $64 – $370 |
| 3 | Anthem fee schedule · outpatient · +4 other terms | 24 | $35 | $46 | $37 | 80% | — | $35 – $220 |
| 4 | UnitedHealthcare fee schedule · outpatient · +1 other terms | 7 | $108 | $101 | $5 | 5% | — | $98 – $109 |
| 5 | Aetna fee schedule · outpatient · +2 other terms | 5 | $108 | $305 | $278 | 91% | — | $108 – $704 |
| 6 | Humana fee schedule · outpatient | 4 | $114 | $114 | $0 | 0% | — | $114 – $114 |
| 7 | Molina fee schedule · outpatient · +1 other terms | 4 | $128 | $134 | $57 | 43% | — | $96 – $258 |
| 8 | Medicaid fee schedule · outpatient | 3 | $98 | $98 | — | — | — | $98 – $98 |
| 9 | WellCare fee schedule · outpatient | 3 | $99 | $99 | $0 | 0% | — | $99 – $100 |
| 10 | Bcbs La facility · fee schedule · outpatient · +1 other terms | 2 | $0 | $0 | — | — | — | $0 – $0 |
← Hospitals reporting CPT 0704T · Snapshot 20261113T090226Z-3ce6c0b8