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North Dakota 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
$1,202.26 / $1,258.93 / $8,511.38
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,202.26 / $1,698.24 / $2,570.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,570.40 / $3,311.31 / $5,128.61