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Maine rates for HCPCS 67028

Intravitreal injection of a pharmacologic agent (separate procedure)

Facilitymedian $2,344 · 10th–90th $1,445–$2,8180%50%10th90th$2,344Professionalmedian $145 · 10th–90th $98–$3800%10%10th90th$145$20.0$50.0$100.0$200.0$500.0$1.0K$2.0K

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
$1,445.44 / $2,344.23 / $2,344.23
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$2,454.71 / $2,454.71 / $2,818.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $141.25 / $380.19
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$151.36 / $154.88 / $741.31
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $128.82 / $151.36
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$112.20 / $194.98 / $229.09
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $537.03 / $537.03
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $190.55 / $251.19
Community Health Options
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $151.36 / $229.09
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $141.25 / $218.78
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $147.91 / $229.09
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$93.33 / $141.25 / $218.78