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Washington, DC rates for HCPCS 67028

Intravitreal injection of a pharmacologic agent (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $2,691.53 / $4,073.80
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.10 / $144.54 / $524.81
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$57.54 / $316.23 / $758.58
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$107.15 / $295.12 / $977.24
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $158.49 / $446.68
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$123.03 / $141.25 / $257.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.80 / $549.54 / $1,862.09
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.20 / $134.90 / $269.15