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South Dakota rates for HCPCS 67028

Intravitreal injection of a pharmacologic agent (separate procedure)

Facilitymedian $355 · 10th–90th $120$1,8200%20%10th90th$355Professionalmedian $158 · 10th–90th $95$3800%10%10th90th$158$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
$120.23 / $354.81 / $1,047.13
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$95.50 / $120.23 / $380.19
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$158.49 / $165.96 / $436.52
Avera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $186.21 / $186.21
Avera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $223.87 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $269.15 / $331.13
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$79.43 / $141.25 / $371.54
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$87.10 / $204.17 / $1,174.90
Medica
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$602.56 / $602.56 / $602.56
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $234.42 / $275.42
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$125.89 / $177.83 / $218.78
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$812.83 / $812.83 / $812.83
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$112.20 / $194.98 / $281.84
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $213.80 / $257.04