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Wisconsin rates for HCPCS 66991

Extracapsular cataract removal with insertion of intraocular lens prosthesis (1 stage procedure), manual or mechanical technique (eg, irrigation and aspiration or phacoemulsification); with insertion of intraocular (eg, trabecular meshwork, supraciliary, suprachoroidal) anterior segment aqueous drainage device, without extraocular reservoir, internal approach, one or more

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,022.24 / $4,540.06 / $14,482.00
Aetna
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$204.45 / $204.45 / $502.74
Aetna
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$766.68 / $766.68 / $1,885.28
Aetna
Facility/Professional
Facility
Modifier
55
Low / Median / High Price
$153.34 / $153.34 / $377.06
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.94 / $911.20 / $6,650.00
Aetna
Facility/Professional
Professional
Modifier
55
Low / Median / High Price
$95.58 / $153.34 / $178.43
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,538.00 / $9,720.00 / $15,579.70
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$673.97 / $1,319.85 / $3,185.61
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,806.75 / $2,111.33 / $3,405.49
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$819.58 / $1,654.95 / $2,465.86
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$626.86 / $971.63 / $1,395.22
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$752.23 / $8,225.90 / $15,702.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$712.77 / $1,360.02 / $4,758.39
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.33 / $348.75 / $1,091.31
Prevea360
Facility/Professional
Facility
Modifier
Low / Median / High Price
$626.86 / $971.63 / $1,395.22
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,037.53 / $1,565.74 / $2,282.13
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$21,325.00 / $21,325.00 / $21,325.00
Quartz
Facility/Professional
Facility
Modifier
53
Low / Median / High Price
$4,042.62 / $4,042.62 / $4,042.62
Quartz
Facility/Professional
Facility
Modifier
54
Low / Median / High Price
$14,149.17 / $14,149.17 / $14,149.17
Quartz
Facility/Professional
Facility
Modifier
55
Low / Median / High Price
$3,031.96 / $3,031.96 / $3,031.96
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$735.13 / $2,901.02 / $5,089.60
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,542.48 / $4,119.43 / $6,628.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,729.00 / $11,799.00 / $16,373.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$712.49 / $1,414.24 / $2,971.42