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Arizona rates for HCPCS 65781

Ocular Surface Reconstruction Limbal Allograft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $4,521.00 / $7,963.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,228.58 / $1,563.80 / $7,032.61
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$944.35 / $3,670.74 / $5,814.97
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,002.44 / $1,196.94 / $1,286.71
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,228.44 / $2,890.91 / $8,215.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.88 / $1,308.91 / $9,867.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,399.46 / $5,596.00 / $8,586.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,024.68 / $1,285.19 / $2,490.64