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Missouri 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
$1,547.00 / $5,389.00 / $12,154.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,088.00 / $4,279.00 / $9,663.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$730.00 / $730.00 / $1,344.16
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,319.02 / $2,845.00 / $26,542.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,438.00 / $2,833.00 / $5,813.00