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Michigan rates for HCPCS 67028

Intravitreal injection of a pharmacologic agent (separate procedure)

Facilitymedian $603 · 10th–90th $155$2,0420%10%10th90th$603Professionalmedian $145 · 10th–90th $83$4680%10%10th90th$145$50.0$100.0$200.0$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
$151.36 / $512.86 / $2,884.03
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$616.60 / $660.69 / $1,479.11
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$69.18 / $125.89 / $346.74
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$158.49 / $208.93 / $724.44
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $112.20 / $123.03
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$138.04 / $138.04 / $165.96
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$204.17 / $204.17 / $204.17
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$134.90 / $204.17 / $204.17
BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$218.78 / $269.15 / $269.15
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $87.10 / $114.82
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $104.71 / $104.71
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$72.44 / $117.49 / $331.13
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $602.56 / $4,897.79
Health Alliance Plan
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$616.60 / $645.65 / $1,479.11
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $131.83 / $281.84
Health Alliance Plan
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$131.83 / $208.93 / $660.69
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$53.70 / $104.71 / $181.97
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $851.14 / $1,698.24
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $239.88