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Alaska rates for HCPCS 67025

Injection of vitreous substitute, pars plana or limbal approach (fluid-gas exchange), with or without aspiration (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,083.25 / $6,541.00 / $13,413.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,450.35 / $3,450.35 / $4,001.30
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$729.31 / $729.31 / $2,362.96
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$762.14 / $923.99 / $5,721.86
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,513.00 / $2,073.96 / $3,827.25
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,246.25 / $2,952.45 / $3,835.05
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$923.99 / $1,092.33 / $5,721.86
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$729.31 / $2,955.15 / $4,124.43
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$906.99 / $1,890.38 / $2,835.57