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Oklahoma rates for HCPCS 67028

Intravitreal Njx Pharmacologic Agt Spx

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$682.00 / $2,444.00 / $7,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$99.30 / $114.04 / $128.69
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$101.90 / $101.90 / $127.38
Ambetter
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$152.85 / $152.85 / $152.85
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$95.20 / $150.84 / $232.08
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.85 / $120.15 / $147.54
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.08 / $61.08 / $61.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.55 / $130.33 / $320.85
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$99.30 / $161.00 / $1,676.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$87.74 / $123.86 / $1,169.94
Medica
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$135.88 / $135.88 / $166.13
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$100.00 / $604.50 / $1,883.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$83.00 / $110.45 / $214.57