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Montana rates for HCPCS 65778

Placement of amniotic membrane on the ocular surface; without sutures

Facilitymedian $1,862 · 10th–90th $74–$2,6920%20%10th90th$1,862Professionalmedian $1,175 · 10th–90th $60–$2,3440%10%20%10th90th$1,175$50.0$200.0$1.0K$5.0K$20.0K$100.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,174.90 / $2,344.23
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $1,698.24
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$67.61 / $67.61 / $67.61
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $114.82 / $1,698.24
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $1,862.09 / $2,344.23
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $1,862.09 / $2,344.23
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$43.65 / $107.15 / $2,818.38
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $85.11 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$602.56 / $602.56 / $1,584.89
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $144.54 / $2,691.53