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Utah rates for HCPCS 65780

Ocular surface reconstruction; amniotic membrane transplantation, multiple layers

Facilitymedian $6,026 · 10th–90th $3,162–$9,7720%10%10th90th$6,026Professionalmedian $871 · 10th–90th $617–$1,4130%10%20%10th90th$871$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
$891.25 / $6,025.60 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$660.69 / $707.95 / $1,412.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $436.52
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
$851.14 / $1,023.29 / $2,454.71
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $912.01 / $1,584.89
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $891.25 / $2,630.27
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
$588.84 / $776.25 / $1,122.02