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Wisconsin rates for HCPCS 65779

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

Facilitymedian $7,586 · 10th–90th $1,349$12,0230%10%10th90th$7,586Professionalmedian $794 · 10th–90th $145$2,5120%5%10th90th$794$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
$213.80 / $1,737.80 / $4,073.80
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $794.33 / $1,862.09
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $7,762.47 / $12,589.25
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$234.42 / $426.58 / $1,318.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,715.35 / $5,888.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $524.81 / $4,265.80
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $1,737.80 / $10,232.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$223.87 / $489.78 / $3,090.30
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$144.54 / $2,041.74 / $11,481.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $2,454.71 / $8,511.38
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $831.76
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$575.44 / $8,511.38 / $9,120.11
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$537.03 / $1,513.56 / $4,466.84
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$158.49 / $1,258.93 / $3,801.89
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$269.15 / $3,388.44 / $3,388.44
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $2,630.27 / $7,943.28
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $5,623.41
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $4,570.88 / $11,481.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,309.57 / $10,232.93 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $1,096.48 / $4,365.16