go back

Louisiana 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
$891.25 / $2,630.27 / $5,888.44
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $4,073.80 / $6,309.57
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$851.14 / $851.14 / $851.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $2,570.40 / $6,165.95