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West Virginia 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
$1,174.90 / $1,174.90 / $2,290.87
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,230.27 / $1,445.44
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,949.84 / $1,949.84 / $2,511.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $2,454.71 / $6,456.54