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Pennsylvania rates for HCPCS 67025

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

Facilitymedian $2,692 · 10th–90th $813–$8,3180%5%10%10th90th$2,692Professionalmedian $741 · 10th–90th $603–$1,2590%20%40%10th90th$741$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$602.56 / $741.31 / $1,258.93
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $6,165.95 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$707.95 / $741.31 / $1,288.25
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $741.31 / $1,230.27
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $912.01 / $1,258.93
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $776.25 / $1,230.27
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $588.84 / $891.25
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $1,995.26 / $6,606.93
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $724.44 / $1,202.26
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $954.99 / $1,737.80
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$309.03 / $602.56 / $2,754.23
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$309.03 / $602.56 / $2,754.23
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,737.80 / $3,890.45 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $741.31 / $1,288.25