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Washington rates for HCPCS 67255

Scleral Reinforcement Spx W/Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,041.48 / $6,470.00 / $20,680.40
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,126.18 / $11,500.00 / $25,481.74
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$734.00 / $734.00 / $4,960.67
Kaiser Permanente
Facility/Professional
Facility
Modifier
Low / Median / High Price
$953.00 / $1,754.44 / $4,350.34
Pacific Source
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,104.08 / $1,297.79 / $1,607.76
Premera BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$903.74 / $903.74 / $937.31
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,170.56 / $10,830.26 / $22,040.55
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,224.00 / $1,862.00 / $10,522.00