go back

Utah rates for HCPCS 65286

Repair of laceration; application of tissue glue, wounds of cornea and/or sclera

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.83 / $3,388.44 / $4,897.79
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $707.95 / $1,122.02
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.38 / $776.25 / $1,174.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $851.14
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $4,073.80 / $9,120.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,047.13 / $1,445.44
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $954.99 / $1,412.54
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $741.31 / $1,202.26
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,698.24 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$436.52 / $645.65 / $1,023.29