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Montana rates for HCPCS 67025

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

Facilitymedian $1,202 · 10th–90th $1,072–$1,5850%50%10th90th$1,202Professionalmedian $955 · 10th–90th $646–$1,8200%20%10th90th$955$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $891.25 / $1,995.26
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$46,773.51 / $75,857.76 / $95,499.26
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $1,148.15
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$977.24 / $977.24 / $977.24
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $741.31 / $1,148.15
MountainHealth Co-op
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,202.26 / $1,348.96
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,202.26 / $1,348.96
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $933.25 / $1,288.25
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $831.76 / $1,202.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$954.99 / $1,445.44 / $4,677.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,148.15 / $1,479.11