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Alaska rates for HCPCS 66172

Fistulization of sclera for glaucoma; trabeculectomy ab externo with scarring from previous ocular surgery or trauma (includes injection of antifibrotic agents)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,386.00 / $9,774.00 / $14,552.94
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,442.18 / $1,754.76 / $9,299.99
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,754.76 / $1,754.76 / $9,299.99