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Michigan rates for HCPCS 66155

Fistulization of sclera for glaucoma; thermocauterization with iridectomy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,125.36 / $1,167.05 / $6,906.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$817.31 / $1,125.36 / $1,167.05
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,532.37 / $4,117.10 / $5,578.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$220.11 / $849.68 / $2,160.23
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$669.36 / $899.23 / $1,718.59
Health Alliance Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$823.99 / $1,125.36 / $6,906.00
Health Alliance Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$823.99 / $953.86 / $1,360.03
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$68.38 / $594.38 / $979.94
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,450.00 / $5,708.00 / $8,884.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$805.52 / $1,011.37 / $1,404.43