go back

Montana rates for HCPCS 65782

Ocular surface reconstruction; limbal conjunctival autograft (includes obtaining graft)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,348.96 / $2,884.03
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $1,949.84 / $2,344.23
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,949.84 / $1,949.84 / $2,344.23
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,659.59 / $2,041.74
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $85.11 / $2,187.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,754.40 / $5,754.40 / $5,754.40
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,698.24 / $1,905.46 / $2,290.87