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Indiana 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
$1,112.57 / $2,859.30 / $14,063.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,807.00 / $6,653.00 / $11,752.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,077.99 / $1,443.17 / $2,182.94
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$560.00 / $798.00 / $1,627.38
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,399.00 / $5,995.00 / $10,413.00