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Indiana rates for HCPCS 65778

Place Amniotic Membra Ocular Surface W/O Sutures

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$50.28 / $1,228.32 / $5,634.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$50.28 / $1,042.08 / $1,474.93
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,124.10 / $1,124.10 / $1,686.17
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$970.00 / $5,790.87 / $8,240.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$45.96 / $54.08 / $80.68
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$68.95 / $81.12 / $121.02
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$40.32 / $53.99 / $96.77
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,124.10 / $1,348.93 / $2,023.40
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$74.09 / $450.00 / $565.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$56.55 / $1,003.82 / $1,856.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$629.00 / $3,817.00 / $5,490.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,220.91 / $1,508.19 / $2,729.10