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Arkansas 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
$1,277.00 / $1,741.73 / $9,034.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,196.23 / $2,196.23 / $2,635.48
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,462.41 / $2,462.41 / $2,462.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$980.00 / $1,650.00 / $4,064.00