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Utah rates for HCPCS 65780

Ocular Surface Reconstruction Amniotic Membrane

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$890.19 / $4,387.00 / $9,078.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$678.83 / $890.19 / $1,424.90
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.01 / $330.32 / $544.39
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,469.55 / $7,330.88 / $10,683.19
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$766.30 / $927.75 / $1,847.05
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $6,097.00 / $8,267.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.49 / $788.43 / $1,092.72