go back

Virginia 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
$119.16 / $5,412.00 / $9,869.64
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$106.81 / $128.06 / $164.16
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$189.87 / $270.39 / $382.11
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$299.77 / $333.08 / $333.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$142.26 / $142.26 / $142.26
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.83 / $164.00 / $319.30
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$103.57 / $121.84 / $155.04
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$119.16 / $164.90 / $226.54
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.00 / $220.00 / $233.00
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$120.51 / $210.82 / $9,929.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$120.51 / $210.82 / $9,929.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.00 / $1,045.00 / $2,364.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.71 / $94.20 / $298.68