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Wisconsin rates for HCPCS 67025

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

Facilitymedian $4,677 · 10th–90th $1,288$7,7620%10%10th90th$4,677Professionalmedian $933 · 10th–90th $603$2,5700%10%10th90th$933$50.0$200.0$1.0K$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
$933.25 / $1,288.25 / $2,691.53
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $776.25 / $1,412.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $4,786.30 / $7,585.78
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,230.27 / $3,235.94
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $2,290.87 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$724.44 / $1,737.80 / $3,548.13
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,174.90 / $3,548.13
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,698.24 / $2,041.74
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $1,288.25 / $8,128.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$758.58 / $1,584.89 / $5,495.41
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $954.99
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $5,754.40 / $7,762.47
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $2,041.74 / $2,818.38
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$851.14 / $1,621.81 / $2,630.27
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $6,918.31 / $6,918.31
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $3,388.44 / $5,754.40
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,951.21 / $2,951.21 / $3,467.37
Security Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $3,715.35 / $3,715.35
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,884.03 / $6,165.95 / $7,244.36
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,677.35 / $7,413.10 / $9,120.11
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$616.60 / $1,148.15 / $2,884.03