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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
$1,258.93 / $1,258.93 / $6,760.83
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,548.13 / $7,079.46 / $16,595.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,162.28 / $4,466.84 / $10,471.29
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $4,265.80 / $8,317.64
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,380.38 / $2,238.72 / $5,495.41
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,248.07 / $8,912.51