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Idaho rates for HCPCS 65091

Evisceration Ocular Contents W/O Implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,897.00 / $4,500.00 / $7,761.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$668.30 / $1,133.83 / $1,699.13
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,398.53 / $9,164.31 / $11,714.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,400.00 / $9,360.00 / $17,870.00