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Ohio rates for HCPCS 65757

Backbench preparation of corneal endothelial allograft prior to transplantation (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$128.06 / $6,927.63 / $11,627.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.31 / $131.59 / $250.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$446.77 / $594.59 / $1,048.86
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.37 / $154.65 / $1,086.68
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$114.54 / $130.16 / $145.69
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.26 / $142.26 / $21,571.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.84 / $148.11 / $272.52
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.94 / $154.03 / $250.04
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.94 / $110.94 / $144.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$226.00 / $881.00 / $2,833.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.20 / $131.19 / $291.77