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New Hampshire rates for HCPCS 65780

Ocular surface reconstruction; amniotic membrane transplantation, multiple layers

Facilitymedian $3,890 · 10th–90th $2,399–$15,8490%10%20%10th90th$3,890Professionalmedian $933 · 10th–90th $631–$1,5850%10%10th90th$933$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
$2,398.83 / $3,890.45 / $15,848.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $891.25 / $1,479.11
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
$512.86 / $977.24 / $1,621.81
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
$630.96 / $1,000.00 / $1,698.24
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
$676.08 / $1,122.02 / $1,995.26
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83