go back

Montana rates for HCPCS 65785

Implantation Intrastromal Corneal Ring Segments

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$534.57 / $2,343.44 / $12,987.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$694.58 / $694.58 / $694.58
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.33 / $694.58 / $3,341.46
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$694.58 / $694.58 / $694.58
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$448.99 / $2,080.21 / $3,545.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,090.00 / $2,090.00 / $2,090.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,352.72 / $3,912.09 / $4,519.14