go back

Michigan 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
$1,071.52 / $4,897.79 / $4,897.79
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$933.25 / $933.25 / $933.25
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$812.83 / $2,398.83 / $6,918.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,778.28 / $4,365.16 / $7,413.10