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
SCREENING OF VISUAL FUNCTION
Low
$0
Average
$224
Median
$20
High
$13.9k
Each hospital's average Aetna rate, under the methodology and billing class chosen below.
132 hospitals; the 90th percentile is 7.0× the 10th. Each bar is a price range and its height is how many hospitals fall in it. Hover a bar, or a row in the ladder, for details.
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145 hospital rates
iThe hospitals that file a Aetna rate for this code, one row per hospital and set of terms (billing class, payment method, setting). Rates under different terms are never blended, so the terms are shown under each hospital’s name. Figures are the hospital’s averages across its plans.| # | Plans | |||||||
|---|---|---|---|---|---|---|---|---|
| 1 | ADVENTIST HEALTH DELANO Delano, CA percent of total billed charges · outpatientfrom % of charges | 1 | $353 | $353 | — | — | — | $353 – $353 |
| 2 | ALBANY MEDICAL CENTER HOSPITAL Albany, NY professional · fee schedule · outpatient | 6 | $21 | $21 | — | — | — | $21 – $21 |
| 3 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $18 | $18 | — | — | — | $18 – $18 |
| 4 | Alice Hyde Medical Center Malone, NY professional · fee schedule · both | 2 | $21 | $21 | $1 | 2% | — | $21 – $22 |
| 5 | Allen Memorial Hospital Corporation Waterloo, IA fee schedule · both | 2 | $37 | $37 | $0 | 1% | — | $36 – $37 |
| 6 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 2 | $42 | $42 | — | — | — | $42 – $42 |
| 7 | AnMed Piedmont Piedmont, SC professional · fee schedule · inpatient | 2 | $17 | $17 | — | — | — | $17 – $17 |
| 8 | AnMed Piedmont Piedmont, SC professional · fee schedule · outpatient | 2 | $17 | $17 | — | — | — | $17 – $17 |
| 9 | Ascension Via Christi Rehabilitation Hospital, Inc. Wichita, KS fee schedule · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 10 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 1 | $95 | $95 | $16 | 17% | — | $79 – $111 |
| 11 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $59 | $59 | — | — | — | $59 – $59 |
| 12 | Baylor Scott & White All Saints Medical Center - Fort Worth Fort Worth, TX facility · percent of total billed charges · outpatientfrom % of charges | 3 | $15 | $12 | $5 | 45% | — | $4 – $16 |
| 13 | Baylor Scott & White Heart and Vascular Hospital - Dallas Dallas, TX facility · percent of total billed charges · outpatientfrom % of charges | 2 | $16 | $16 | $1 | 4% | — | $15 – $16 |
| 14 | Baylor Scott & White Heart and Vascular Hospital - Waxahachie Waxahachie, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 15 | Baylor Scott & White Medical Center - Centennial Frisco, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 16 | Baylor Scott & White Medical Center - Frisco at PGA Parkway Frisco, TX facility · percent of total billed charges · outpatientfrom % of charges | 2 | $16 | $16 | $1 | 4% | — | $15 – $16 |
| 17 | Baylor Scott & White Medical Center - Grapevine Grapevine, TX facility · percent of total billed charges · outpatientfrom % of charges | 3 | $15 | $12 | $5 | 46% | — | $4 – $16 |
| 18 | Baylor Scott & White Medical Center - Irving Irving, TX facility · percent of total billed charges · outpatientfrom % of charges | 2 | $16 | $16 | $1 | 4% | — | $15 – $16 |
| 19 | Baylor Scott & White Medical Center - Lake Pointe Rowlett, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 20 | Baylor Scott & White Medical Center - McKinney McKinney, TX facility · percent of total billed charges · outpatientfrom % of charges | 2 | $16 | $16 | $1 | 4% | — | $15 – $16 |
| 21 | Baylor Scott & White Medical Center - Plano Plano, TX facility · percent of total billed charges · outpatientfrom % of charges | 2 | $16 | $16 | $1 | 4% | — | $15 – $16 |
| 22 | Baylor Scott & White Medical Center at Waxahachie Waxahachie, TX facility · percent of total billed charges · outpatientfrom % of charges | 2 | $16 | $16 | $1 | 4% | — | $15 – $16 |
| 23 | Baylor Scott & White The Heart Hospital - Denton Denton, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 24 | Baylor Scott & White The Heart Hospital - McKinney McKinney, TX facility · percent of total billed charges · outpatientfrom % of charges | 1 | $15 | $15 | — | — | — | $15 – $15 |
| 25 | Baylor Scott & White The Heart Hospital - Plano Plano, TX facility · percent of total billed charges · outpatientfrom % of charges | 2 | $16 | $16 | $1 | 4% | — | $15 – $16 |
← Payers reporting CPT 99172 · Snapshot 20261113T090226Z-3ce6c0b8