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Minnesota rates for HCPCS 67028

Intravitreal Njx Pharmacologic Agt Spx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.53 / $352.39 / $2,035.05
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$1,817.21 / $1,817.21 / $1,928.03
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.72 / $119.66 / $470.40
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$35.79 / $177.95 / $635.89
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$440.15 / $1,004.27 / $2,211.92
BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$772.24 / $1,171.66 / $2,054.41
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$152.56 / $220.45 / $383.87
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$217.37 / $322.67 / $533.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.17 / $398.94 / $959.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.29 / $282.31 / $480.54
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$228.69 / $364.73 / $755.68
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$164.53 / $260.22 / $451.67
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$113.14 / $226.28 / $1,097.33
Medica
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$590.71 / $1,068.11 / $1,793.28
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$132.46 / $259.80 / $822.85
Medica
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$270.66 / $393.44 / $1,085.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$563.00 / $1,749.00 / $2,883.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$113.54 / $183.40 / $376.75