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Utah rates for HCPCS 65779

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

Facilitymedian $3,162 · 10th–90th $1,175–$6,0260%10%10th90th$3,162Professionalmedian $1,175 · 10th–90th $151–$2,0420%10%10th90th$1,175$50.0$200.0$1.0K$5.0K

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
$1,174.90 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $1,174.90 / $2,041.74
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$138.04 / $1,023.29 / $1,995.26
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $2,137.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $7,413.10 / $11,220.18
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $616.60 / $2,398.83
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$117.49 / $1,148.15 / $2,691.53
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $1,348.96 / $2,187.76
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $8,317.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$147.91 / $1,023.29 / $1,737.80