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Missouri rates for HCPCS 65779

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$616.60 / $2,398.83 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$147.91 / $954.99 / $1,698.24
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.08 / $1,819.70 / $4,168.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$158.49 / $263.03 / $416.87
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.13 / $1,096.48 / $1,737.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $588.84 / $588.84
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$117.49 / $794.33 / $2,137.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $1,584.89 / $4,570.88
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,584.89 / $8,511.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,137.96 / $3,019.95 / $5,754.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$151.36 / $1,023.29 / $1,819.70