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Wisconsin rates for HCPCS 65781

Ocular surface reconstruction; limbal stem cell allograft (eg, cadaveric or living donor)

Facilitymedian $10,471 · 10th–90th $5,012–$16,9820%5%10%10th90th$10,471Professionalmedian $1,995 · 10th–90th $1,230–$5,1290%10%10th90th$1,995$50.0$200.0$1.0K$5.0K$20.0K

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
$1,995.26 / $2,754.23 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,445.44 / $2,754.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,570.40 / $6,456.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $4,073.80 / $6,456.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,187.76 / $4,265.80 / $4,897.79
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $5,754.40 / $10,232.93
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,311.31 / $3,890.45
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $5,248.07 / $15,135.61
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $2,630.27 / $9,772.37
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $85.11
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $9,332.54 / $15,848.93
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $3,801.89 / $5,888.44
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,630.27 / $4,073.80
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$13,803.84 / $19,952.62 / $19,952.62
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,456.54 / $9,549.93 / $9,549.93
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$6,165.95 / $6,165.95 / $6,165.95
Security Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$12,302.69 / $12,302.69 / $12,302.69
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,128.61 / $12,882.50 / $12,882.50
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $14,454.40
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $2,238.72 / $5,623.41