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Washington 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

Facilitymedian $1,660 · 10th–90th $891–$17,7830%10%10th90th$1,660$500.0$1.0K$2.0K$5.0K$10.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $8,128.31 / $20,892.96
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $6,165.95 / $12,589.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $2,884.03
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$776.25 / $1,479.11 / $3,311.31
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$741.31 / $1,202.26 / $1,258.93
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $831.76 / $870.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,466.84 / $6,456.54 / $12,589.25
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $6,606.93 / $12,882.50