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New Hampshire rates for HCPCS 65778

Placement of amniotic membrane on the ocular surface; without sutures

Facilitymedian $2,399 · 10th–90th $1,585–$9,7720%20%10th90th$2,399Professionalmedian $132 · 10th–90th $54–$2,8840%5%10%10th90th$132$50.0$200.0$1.0K$5.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,398.83 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $181.97 / $3,162.28
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $1,737.80 / $3,890.45
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$35.48 / $77.62 / $229.09
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$53.70 / $117.49 / $223.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$54.95 / $181.97 / $3,019.95
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$46.77 / $1,412.54 / $3,162.28
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,709.64 / $8,709.64 / $8,709.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$60.26 / $1,412.54 / $3,388.44
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,698.24 / $1,698.24