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Minnesota 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
$1,271.14 / $1,271.14 / $7,176.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,028.61 / $6,345.45 / $10,207.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,963.24 / $4,204.41 / $10,114.28
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,410.14 / $3,843.84 / $7,964.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,390.43 / $2,248.03 / $5,499.18
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,735.00 / $4,974.00 / $8,812.00