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Unlisted Procedure On The Eye's Surface Membrane

Pennsylvania rates for HCPCS 68399

Covers an operation on the conjunctiva — the thin clear membrane that covers the white of the eye and lines the inside of the eyelids — where no standard named entry fits. The surgeon submits a written report describing exactly what was done.

Rates data updated July 2026.

How much does Unlisted Procedure On The Eye's Surface Membrane cost?

$5,370

Typical negotiated rate. In Pennsylvania, July 2026.

Insurers have agreed to pay about $5,370 for this service. The price depends on where it is billed: about $57,544 from a physician practice, and about $4,786 from a hospital or other facility. The two figures are alternatives, not parts of one bill.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 6 insurance carriers under federal price transparency rules.

Where it's billed changes the price

Billed byTypicalRange
Physician practiceA doctor's office, clinic or independent provider$57,544$1,585 to $64,565
FacilityA hospital or hospital-owned outpatient department$4,786$1,413 to $7,762

How much rates vary

Facilitymedian $4,786 · 10th to 90th $363 to $8,318Professionalmedian $57,544 · 10th to 90th $1,413 to $64,565
$100$1K$10Kfacility $4,786professional $57,544

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,288.25
Median
$5,754.40
Typical High
$8,511.38
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,412.54
Median
$1,584.89
Typical High
$7,762.47
Capital Blue Cross
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$2,570.40
Typical High
$57,543.99
Capital Blue Cross
Setting
Professional
Modifier
Global
Typical Low
$64,565.42
Median
$64,565.42
Typical High
$64,565.42
Cigna
Setting
Facility
Modifier
Global
Typical Low
$676.08
Median
$676.08
Typical High
$676.08
Martin's Point
Setting
Facility
Modifier
Global
Typical Low
$831.76
Median
$4,786.30
Typical High
$8,511.38
Martin's Point
Setting
Professional
Modifier
Global
Typical Low
$446.68
Median
$1,584.89
Typical High
$7,762.47
UPMC Health Plan
Setting
Facility
Modifier
Global
Typical Low
$26.30
Median
$35.48
Typical High
$63.10
United
Setting
Facility
Modifier
Global
Typical Low
$354.81
Median
$707.95
Typical High
$3,890.45

Where Pennsylvania sits

The same service costs 83.2 times more in Wisconsin than in South Dakota. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Pennsylvania· 9th of 50

$5,370

WI $12,589SD $151

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.