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Montana rates for HCPCS 65855

Trabeculoplasty by laser surgery

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$912.01 / $912.01 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $302.00 / $575.44
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$309.03 / $588.84 / $851.14
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46,773.51 / $81,283.05 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $323.59 / $380.19
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$323.59 / $323.59 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.93 / $323.59 / $549.54
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Low / Median / High Price
$346.74 / $416.87 / $562.34
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Low / Median / High Price
$346.74 / $416.87 / $562.34
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$302.00 / $416.87 / $1,174.90
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$79.43 / $288.40 / $467.74
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$398.11 / $398.11 / $398.11
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$323.59 / $398.11 / $501.19