go back

Maine rates for HCPCS 65779

Placement of amniotic membrane on the ocular surface; single layer, sutured

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $588.84 / $1,905.46
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $154.88 / $588.84
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $707.95 / $707.95
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $1,513.56 / $2,511.89
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $758.58 / $2,187.76
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$144.54 / $588.84 / $1,905.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $933.25 / $2,137.96