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Nebraska 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
$4,265.80 / $7,585.78 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $954.99 / $4,897.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,786.30 / $6,309.57 / $12,302.69
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$794.33 / $1,348.96 / $1,905.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $2,630.27 / $2,630.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,995.26 / $2,511.89
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$794.33 / $1,548.82 / $8,912.51
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$954.99 / $1,479.11 / $2,238.72
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,737.80 / $2,630.27
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $2,630.27 / $2,630.27
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,659.59 / $1,862.09 / $2,238.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,677.35 / $5,888.44 / $8,912.51
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$933.25 / $1,584.89 / $2,041.74