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Nebraska 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
$5,005.00 / $10,431.19 / $20,928.72
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,889.38 / $7,684.16 / $14,983.55
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,821.47 / $1,821.47 / $1,821.47
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,112.57 / $2,576.52 / $7,934.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,409.14 / $2,308.21 / $3,155.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,217.00 / $6,451.00 / $7,934.00