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Utah rates for HCPCS 67015

Aspiration or release of vitreous, subretinal or choroidal fluid, pars plana approach (posterior sclerotomy)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$588.84 / $3,162.28 / $4,570.88
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $630.96 / $1,288.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$457.09 / $831.76 / $1,071.52
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $1,348.96
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,467.37 / $4,073.80 / $9,120.11
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$776.25 / $1,023.29 / $1,230.27
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$524.81 / $1,047.13 / $1,479.11
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$741.31 / $891.25 / $1,584.89
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,995.26 / $5,128.61 / $7,079.46
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $602.56 / $977.24