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Nebraska 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
$689.36 / $4,241.22 / $13,841.56
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$584.48 / $972.64 / $3,340.98
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,180.02 / $5,453.87 / $10,634.64
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$613.08 / $1,045.01 / $1,406.04
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,821.47 / $1,821.47 / $1,821.47
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,385.10 / $1,695.32 / $2,119.15
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$689.36 / $1,141.25 / $5,156.62
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,002.53 / $1,501.95 / $1,997.13
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,110.00 / $1,695.91 / $2,307.19
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,121.00 / $1,492.54 / $1,972.02
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,217.00 / $6,451.00 / $7,934.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.86 / $1,550.85 / $1,956.02