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Utah rates for HCPCS 65155

Reinsertion of ocular implant; with use of foreign material for reinforcement and/or attachment of muscles to implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$870.96 / $5,888.44 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$870.96 / $1,000.00 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,288.25 / $1,621.81
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $707.95
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,495.41 / $6,456.54 / $14,791.08
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,659.59 / $1,862.09
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$851.14 / $1,479.11 / $1,819.70
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,348.96 / $1,862.09
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $891.25 / $1,479.11