go back

Idaho 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
$3,422.00 / $4,500.00 / $8,622.00
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,068.28 / $2,247.90 / $3,017.61
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,116.89 / $5,756.01 / $7,201.73
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,150.00 / $5,550.00 / $12,233.00