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Nationwide rates for HCPCS 65875

Severing adhesions of anterior segment of eye, incisional technique (with or without injection of air or liquid) (separate procedure); posterior synechiae

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,047.13 / $4,786.30 / $11,481.54
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,630.27 / $7,585.78 / $14,791.08
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $1,698.24 / $4,677.35
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,445.44 / $4,168.69 / $9,549.93