go back

California 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
$693.62 / $4,848.00 / $16,109.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.60 / $743.63 / $1,908.00
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$616.11 / $616.11 / $636.13
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,723.00 / $4,617.00 / $9,381.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$578.80 / $870.08 / $1,749.91
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $5,591.57
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$470.83 / $672.61 / $1,491.52
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$372.64 / $1,726.46 / $2,353.27
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$581.54 / $823.66 / $1,757.71
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$505.96 / $897.15 / $1,211.15
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$605.22 / $850.37 / $1,507.97
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,002.89 / $5,156.62 / $12,000.00
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$4,556.39 / $5,516.40 / $6,062.55
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$738.71 / $927.03 / $1,286.51
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$593.38 / $881.83 / $1,844.68
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,073.02 / $2,073.02 / $2,438.46
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.04 / $815.92 / $997.24
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,523.00 / $7,359.00 / $15,471.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$564.29 / $731.50 / $2,025.84