go back

West Virginia rates for HCPCS 67255

Scleral Reinforcement Spx W/Graft

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$679.66 / $679.66 / $1,700.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$704.48 / $764.62 / $833.06
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$764.66 / $764.66 / $764.66