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Maryland 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
$1,410.72 / $1,410.72 / $1,423.43
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$599.00 / $634.82 / $1,205.38
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,216.59 / $1,399.09 / $1,824.90
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,009.00 / $1,009.00 / $1,009.00