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Montana rates for HCPCS 65780

Ocular surface reconstruction; amniotic membrane transplantation, multiple layers

Facilitymedian $1,122 · 10th–90th $1,000–$10,9650%50%10th90th$1,122Professionalmedian $851 · 10th–90th $708–$1,4790%20%10th90th$851$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
$707.95 / $812.83 / $1,479.11
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
$933.25 / $933.25 / $933.25
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,047.13 / $1,479.11
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,047.13 / $1,479.11
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,148.15 / $1,548.82
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $85.11 / $1,148.15
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $5,754.40 / $7,943.28
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,148.15 / $1,412.54