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South Dakota rates for HCPCS 67025

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

Facilitymedian $794 · 10th–90th $646–$4,3650%10%20%10th90th$794Professionalmedian $891 · 10th–90th $631–$1,5850%10%10th90th$891$500.0$1.0K$2.0K$5.0K

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
$676.08 / $794.33 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$575.44 / $794.33 / $1,148.15
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,318.26 / $1,737.80 / $2,187.76
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $933.25 / $1,778.28
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$630.96 / $1,318.26 / $4,677.35
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,698.24 / $1,778.28
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,202.26 / $1,412.54
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $2,691.53 / $4,677.35
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$645.65 / $1,258.93 / $1,995.26
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,445.44 / $1,698.24