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 Test Visual Acuity Quantitative Bilat
Low
$2
Average
$188
Median
$7
High
$25k
Each hospital's average Molina rate, under the methodology and billing class chosen below.
159 hospitals; the 90th percentile is 39.2× 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.
Filter by billing methodology
Filter by billing class
202 hospital rates
iThe hospitals that file a Molina 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 | PRISMA HEALTH BAPTIST EASLEY HOSPITAL EASLEY, SC per diem · both | 1 | $123 | $123 | — | — | 22 | $123 – $123 |
| 2 | PRISMA HEALTH GREENVILLE MEMORIAL HOSPITAL GREENVILLE, SC per diem · both | 1 | $123 | $123 | — | — | 22 | $123 – $123 |
| 3 | PRISMA HEALTH BAPTIST PARKRIDGE HOSPITAL COLUMBIA, SC per diem · both | 1 | $124 | $124 | — | — | 2–20 | $124 – $124 |
| 4 | PRISMA HEALTH RICHLAND HOSPITAL COLUMBIA, SC per diem · both | 1 | $124 | $124 | — | — | 2–20 | $124 – $124 |
| 5 | University of New Mexico Hospital | UNM Sandoval Regional Medical Center - A Campus of UNM Hospital Rio Rancho, NM facility · other · outpatient | 1 | $146 | $146 | — | — | 2–20 | $146 – $146 |
| 6 | Deaconess Health System Henderson Hospital Henderson, KY facility · other · inpatient | 1 | $26 | $26 | — | — | 1–10 | $26 – $26 |
| 7 | Deaconess Health System Henderson Hospital Henderson, KY facility · other · outpatient | 1 | $26 | $26 | — | — | 1–10 | $26 – $26 |
| 8 | Mercy Health Lakeshore Campus Shelby, MI professional · percent of total billed charges · outpatientfrom % of charges | 2 | $2 | $2 | — | — | 1–10 | $2 – $2 |
| 9 | Mercy Health Saint Marys Rockford, MI professional · percent of total billed charges · outpatientfrom % of charges | 2 | $2 | $2 | — | — | 1–10 | $2 – $2 |
| 10 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 11 | AKRON GENERAL MEDICAL CENTER Akron, OH professional · fee schedule · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 12 | AMH Cath Labs LLC Arlington, TX case rate · outpatient | 1 | $3 | $3 | — | — | — | $3 – $3 |
| 13 | Adena Fayette Medical Center Washington Court House, OH facility · case rate · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 14 | Adena Health System Chillicothe, OH facility · fee schedule · outpatient | 2 | $5 | $5 | $2 | 34% | — | $3 – $6 |
| 15 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE fee schedule · outpatient | 1 | $2 | $2 | — | — | — | $2 – $2 |
| 16 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE other · outpatient | 1 | $29 | $29 | — | — | — | $29 – $29 |
| 17 | BELLEVUE MEDICAL CENTER LLC Bellevue, NE percent of total billed charges · outpatientfrom % of charges | 2 | $12 | $12 | $0 | 1% | — | $12 – $12 |
| 18 | Baptist Memorial Hospital-Collierville Collierville, TN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 19 | Baptist Memorial Hospital-Collierville Collierville, TN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $25 | $25 | — | — | — | $25 – $25 |
| 20 | Baptist Memorial Hospital-Memphis Memphis, TN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 21 | Baptist Memorial Hospital-Memphis Memphis, TN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $25 | $25 | — | — | — | $25 – $25 |
| 22 | Baptist Memorial Hospital-Women's Memphis, TN facility · percent of total billed charges · inpatientfrom % of charges | 1 | $25 | $25 | — | — | — | $25 – $25 |
| 23 | Baptist Memorial Hospital-Women's Memphis, TN facility · percent of total billed charges · outpatientfrom % of charges | 2 | $25 | $25 | — | — | — | $25 – $25 |
| 24 | Bronson LakeView Hospital Paw Paw, MI facility · percent of total billed charges · outpatientfrom % of charges | 1 | $13 | $13 | $2 | 13% | — | $11 – $15 |
| 25 | CATHOLIC HEALTH INITIATIVES COLORADO West Valley City, UT fee schedule · outpatient | 2 | $5 | $5 | $2 | 35% | — | $3 – $7 |
← Payers reporting CPT 99173 · Snapshot 20261111T120946Z-9134e7f7