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Idaho 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
$1,412.54 / $4,466.84 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $1,148.15 / $1,698.24
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,511.89 / $4,073.80 / $6,760.83
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,202.26 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$501.19 / $870.96 / $1,258.93
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$537.03 / $1,096.48 / $1,905.46
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $1,071.52 / $1,479.11
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,168.69 / $5,248.07 / $7,585.78
Regence BlueShield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,318.26 / $1,548.82
Select Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,174.90 / $5,754.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,148.15 / $5,495.41 / $12,302.69
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$676.08 / $912.01 / $1,348.96