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Amniotic Membrane Placement On The Eye Surface

New Hampshire rates for HCPCS 65779

A thin membrane derived from placental tissue is placed over the surface of the eye and held in position to help protect the eye and support healing after an injury, infection, or other damage. The membrane provides a biological covering that encourages the eye's own tissue to repair itself.

Rates data updated July 2026.

How much does Amniotic Membrane Placement On The Eye Surface cost?

$4,104

Typical total for the visit. In New Hampshire, July 2026.

Insurers have agreed to pay about $4,104 for this procedure. That total is two separate charges: $302 to the doctor who performs it, and $3,802 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$302$174 to $1,820
Facility feeThe hospital or surgery center$3,802$1,230 to $6,310

How much rates vary

Facilitymedian $3,802 · 10th to 90th $302 to $9,772Professionalmedian $302 · 10th to 90th $110 to $2,512
$100$200$500$1K$2K$5K$10Kfacility $3,802professional $302

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$302.00
Median
$1,230.27
Typical High
$9,772.37
Aetna
Setting
Professional
Modifier
Global
Typical Low
$257.04
Median
$302.00
Typical High
$2,511.89
Anthem BCBS
Setting
Facility
Modifier
Global
Typical Low
$3,467.37
Median
$4,677.35
Typical High
$6,309.57
Anthem BCBS
Setting
Professional
Modifier
Global
Typical Low
$85.11
Median
$173.78
Typical High
$616.60
Cigna
Setting
Professional
Modifier
Global
Typical Low
$144.54
Median
$338.84
Typical High
$2,630.27
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$10,000.00
Typical High
$10,000.00
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$109.65
Median
$1,258.93
Typical High
$2,884.03
United
Setting
Facility
Modifier
Global
Typical Low
$10,000.00
Median
$10,000.00
Typical High
$10,000.00
United
Setting
Professional
Modifier
Global
Typical Low
$154.88
Median
$1,258.93
Typical High
$3,388.44
Well Sense
Setting
Facility
Modifier
Global
Typical Low
$1,445.44
Median
$1,445.44
Typical High
$1,445.44

Where New Hampshire sits

The same service costs 11.1 times more in Indiana than in Maine. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

New Hampshire· 21st of 50

$4,104

$302 physician + $3,802 facility

IN $10,596ME $953

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.