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Indiana rates for HCPCS 67028

Intravitreal injection of a pharmacologic agent (separate procedure)

Facilitymedian $3,467 · 10th–90th $186$7,4130%5%10th90th$3,467Professionalmedian $151 · 10th–90th $91$4790%10%10th90th$151$20.0$100.0$500.0$2.0K$10.0K

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
$107.15 / $1,174.90 / $4,897.79
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$707.95 / $707.95 / $707.95
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $128.82 / $389.05
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$138.04 / $316.23 / $776.25
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $107.15 / $162.18
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$162.18 / $162.18 / $239.88
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,819.70 / $4,265.80 / $8,317.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $158.49 / $223.87
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$154.88 / $234.42 / $331.13
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$83.18 / $93.33 / $117.49
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $112.20 / $138.04
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $77.62 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $154.88 / $331.13
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$257.04 / $2,137.96 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $134.90 / $229.09
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$95.50 / $95.50 / $95.50