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Texas rates for HCPCS 67028

Intravitreal injection of a pharmacologic agent (separate procedure)

Facilitymedian $912 · 10th–90th $74$4,6770%5%10th90th$912Professionalmedian $126 · 10th–90th $81$3310%10%10th90th$126$20.0$100.0$500.0$2.0K$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
$407.38 / $1,862.09 / $6,309.57
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$281.84 / $794.33 / $3,890.45
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $123.03 / $257.04
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$125.89 / $281.84 / $630.96
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $114.82 / $131.83
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$147.91 / $177.83 / $194.98
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$45.71 / $74.13 / $316.23
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$74.13 / $91.20 / $151.36
Baylor Scott & White
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$93.33 / $354.81 / $1,584.89
Baylor Scott & White
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$102.33 / $138.04 / $204.17
Christus
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$74.13 / $302.00 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$72.44 / $72.44 / $74.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $281.84
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$54.95 / $56.23 / $1,288.25
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$144.54 / $891.25 / $3,235.94
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$97.72 / $257.04 / $3,467.37
Moda Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$281.84 / $741.31 / $3,890.45
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $128.82 / $251.19
Moda Health
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$162.18 / $281.84 / $549.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $120.23
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,344.23 / $3,019.95
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $141.25 / $239.88
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$91.20 / $144.54 / $371.54
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$100.00 / $131.83 / $239.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$162.18 / $812.83 / $2,187.76
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$81.28 / $112.20 / $223.87
United
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$89.13 / $89.13 / $89.13
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$109.65 / $114.82 / $114.82