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Minnesota rates for HCPCS 0100T

Placement of a subconjunctival retinal prosthesis receiver and pulse generator, and implantation of intra-ocular retinal electrode array, with vitrectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,819.70 / $1,819.70 / $7,762.47
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,148.15 / $1,819.70 / $2,344.23
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,630.78 / $6,606.93 / $16,595.87
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,365.16 / $4,365.16 / $4,365.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,905.46 / $3,090.30 / $26,915.35
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,905.46 / $3,235.94 / $7,762.47
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,897.79 / $16,218.10 / $53,703.18
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,819.70 / $2,884.03 / $6,165.95