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
Instrument Based Ocular Scr Bi W/Onsite Analysis
Low
$0
Average
$351
Median
$9
High
$29.3k
Each hospital's average Anthem rate, under the methodology and billing class chosen below.
170 hospitals; the 90th percentile is 15.7× 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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208 hospital rates
iThe hospitals that file a Anthem 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 | University of Wisconsin Hospital and Clinics Authority WI 53718; 1675 Highland Ave Madison, WI percent of total billed chargesfrom % of charges | 4 | $28 | $29 | $9 | 30% | 353–362 | $18 – $41 |
| 2 | St Mary Mercy Livonia Livonia, MI professional · fee schedule · outpatient | 2 | $8 | $7 | $2 | 26% | 1–10 | $3 – $8 |
| 3 | The Medical Center of Central Georgia Inc Macon, GA percent of total billed charges · outpatientfrom % of charges | 1 | $147 | $147 | — | — | 1–10 | $147 – $147 |
| 4 | AKRON GENERAL MEDICAL CENTER Akron, OH facility · case rate · outpatient | 1 | $56 | $56 | — | — | — | $56 – $56 |
| 5 | ALICE_PECK_DAY_MEMORIAL_HOSPITAL LEBANON, NH percent of total billed charges · outpatientfrom % of charges | 1 | $9 | $9 | — | — | — | $9 – $9 |
| 6 | Acadia Hospital Bangor, ME professional · fee schedule · outpatient | 1 | $7 | $7 | — | — | — | $7 – $7 |
| 7 | Alta Newport Hospital, LLC Tustin, CA facility · case rate · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 8 | Ascension Calumet Hospital, Inc. Chilton, WI fee schedule · outpatient | 4 | $5 | $5 | — | — | — | $5 – $5 |
| 9 | Ascension NE Wisconsin, Inc. Appleton, WI fee schedule · outpatient | 4 | $5 | $5 | — | — | — | $5 – $5 |
| 10 | Ascension NE Wisconsin, Inc. Oshkosh, WI fee schedule · outpatient | 4 | $5 | $5 | — | — | — | $5 – $5 |
| 11 | Ascension St. Vincent Heart Center Carmel, IN fee schedule · outpatient | 8 | $23 | $23 | — | — | — | $23 – $23 |
| 12 | Aspirus Rhinelander Hospital Rhinelander, WI fee schedule · both | 2 | $7 | $7 | $3 | 45% | — | $4 – $10 |
| 13 | Blue Hill Memorial Hospital Hill, ME professional · fee schedule · outpatient | 2 | $9 | $9 | — | — | — | $9 – $9 |
| 14 | Boulder Community Health Lafayette, CO facility · case rate · outpatient | 1 | $6 | $6 | — | — | — | $6 – $6 |
| 15 | Boulder Community Health Lafayette, CO professional · fee schedule · both | 2 | $6 | $7 | $1 | 15% | — | $6 – $8 |
| 16 | CATHOLIC HEALTH INIATIVES COLORADO Westminster, CO fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 17 | CATHOLIC HEALTH INITIATIVES COLORADO Pueblo, CO fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 18 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 19 | CATHOLIC HEALTH INITIATIVES COLORADO Frisco, CO fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 20 | CATHOLIC HEALTH INITIATIVES COLORADO Durango, CO fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 21 | CATHOLIC HEALTH INITIATIVES COLORADO Lakewood, CO fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 22 | CATHOLIC HEALTH INITIATIVES COLORADO Colorado Springs, CO fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 23 | CATHOLIC HEALTH INITIATIVES COLORADO Fort Morgan, CO fee schedule · outpatient | 1 | $5 | $5 | — | — | — | $5 – $5 |
| 24 | CLEVELAND CLINIC AVON HOSPITAL Avon, OH facility · case rate · outpatient | 1 | $54 | $54 | — | — | — | $54 – $54 |
| 25 | CLEVELAND CLINIC CHILDREN'S HOSPITAL FOR REHABILITATION Cleveland, OH facility · case rate · outpatient | 1 | $98 | $98 | — | — | — | $98 – $98 |
← Payers reporting CPT 99177 · Snapshot 20261111T120946Z-9134e7f7