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Louisiana 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
$524.81 / $1,288.25 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.96 / $870.96 / $1,258.93
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$562.34 / $562.34 / $562.34
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,187.76 / $4,265.80 / $8,128.31
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$707.95 / $851.14 / $1,047.13
Christus
Facility/Professional
Facility
Modifier
Low / Median / High Price
$39.81 / $39.81 / $39.81
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$446.68 / $446.68 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$588.84 / $812.83 / $1,148.15
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $2,570.40 / $6,165.95
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $724.44 / $1,202.26