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Ohio 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
$934.40 / $5,201.00 / $11,627.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,152.00 / $3,025.00 / $8,800.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$752.93 / $923.07 / $1,525.80
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$704.26 / $1,124.08 / $21,571.00
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,124.08 / $1,124.08 / $1,253.49
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,981.00 / $4,072.00 / $6,522.00