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Missouri rates for HCPCS 65290

Repair of wound, extraocular muscle, tendon and/or Tenon's capsule

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
$364.86 / $542.22 / $749.28
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
$420.17 / $556.28 / $823.01
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
$387.15 / $586.41 / $1,198.72
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.22 / $2,297.00 / $26,542.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.08 / $589.37 / $3,648.72
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
$450.43 / $583.45 / $944.58