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New Hampshire rates for HCPCS 67028

Intravitreal injection of a pharmacologic agent (separate procedure)

Facilitymedian $1,349 · 10th–90th $195–$8,9130%10%10th90th$1,349Professionalmedian $151 · 10th–90th $100–$2880%10%10th90th$151$100.0$200.0$500.0$1.0K$2.0K$5.0K$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
$194.98 / $1,348.96 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $128.82 / $281.84
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$323.59 / $323.59 / $323.59
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,412.54 / $3,467.37
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $138.04 / $218.78
Anthem BCBS
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$112.20 / $223.87 / $323.59
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$114.82 / $173.78 / $275.42
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$97.72 / $158.49 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $7,413.10 / $7,413.10
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $173.78 / $323.59
Well Sense
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $138.04