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Indiana rates for HCPCS 0253T

Insertion of anterior segment aqueous drainage device, without extraocular reservoir, internal approach, into the suprachoroidal space

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $4,897.79 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$575.44 / $758.58 / $1,000.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,317.64 / $19,952.62 / $27,542.29
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,412.54 / $2,089.30
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$977.24 / $15,488.17 / $43,651.58
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $1,698.24 / $3,981.07
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $831.76 / $4,570.88
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $9,549.93 / $16,218.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $1,023.29 / $1,659.59