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New Hampshire rates for HCPCS 65779

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

Facilitymedian $1,820 · 10th–90th $302–$9,7720%10%20%10th90th$1,820Professionalmedian $347 · 10th–90th $112–$2,5700%5%10%10th90th$347$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$302.00 / $1,819.70 / $9,772.37
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$177.83 / $489.78 / $1,905.46
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,677.35 / $6,309.57
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $186.21 / $616.60
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $338.84 / $2,630.27
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,000.00 / $10,000.00
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $1,258.93 / $2,884.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$10,000.00 / $10,000.00 / $10,000.00
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $1,258.93 / $3,388.44
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44