go back

Missouri rates for HCPCS 65130

Insertion of ocular implant secondary; after evisceration, in scleral shell

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,258.00 / $4,261.00 / $8,000.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.34 / $952.79 / $1,313.64
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,247.00 / $9,663.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$621.00 / $828.25 / $1,303.64
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$591.00 / $591.00 / $1,756.75
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$636.11 / $932.14 / $1,839.84
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.93 / $2,370.67 / $26,542.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$670.70 / $944.64 / $6,367.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,748.00 / $3,502.00 / $6,854.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$670.70 / $944.50 / $1,592.64