go back

Virginia rates for HCPCS 67255

Scleral Reinforcement Spx W/Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$876.69 / $5,087.00 / $8,294.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,060.00 / $3,693.00 / $4,290.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$764.66 / $764.66 / $764.66
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.37 / $751.02 / $963.07
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$628.97 / $944.87 / $1,481.61
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$686.19 / $953.47 / $7,420.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,349.00 / $6,870.00 / $12,739.00