go back

Wisconsin rates for HCPCS 65175

Removal Ocular Implant

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,186.22 / $1,894.00 / $14,482.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,060.00 / $7,344.00 / $10,517.23
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,099.61 / $2,453.56 / $3,957.51
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$710.94 / $947.67 / $1,423.46
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$744.84 / $4,240.00 / $11,598.00
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$672.00 / $947.67 / $1,598.33
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,381.20 / $1,823.18 / $2,587.91
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$9,001.70 / $9,001.70 / $9,001.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,241.00 / $9,837.00 / $12,062.00