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Montana rates for HCPCS 65779

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

Facilitymedian $1,995 · 10th–90th $200–$2,5120%20%40%10th90th$1,995Professionalmedian $646 · 10th–90th $158–$2,0420%10%10th90th$646$100.0$500.0$2.0K$10.0K$50.0K

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
$158.49 / $645.65 / $2,041.74
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
$181.97 / $181.97 / $1,819.70
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $181.97 / $181.97
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $467.74 / $1,819.70
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$199.53 / $1,995.26 / $2,137.96
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $1,995.26 / $2,137.96
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$102.33 / $416.87 / $2,511.89
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $208.93 / $1,905.46
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,412.54 / $1,479.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $707.95 / $2,238.72