go back

Utah rates for HCPCS 67028

Intravitreal injection of a pharmacologic agent (separate procedure)

Facilitymedian $2,239 · 10th–90th $135–$4,5710%10%10th90th$2,239Professionalmedian $132 · 10th–90th $85–$2570%10%10th90th$132$20.0$100.0$500.0$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
$134.90 / $2,951.21 / $4,570.88
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$831.76 / $1,148.15 / $1,148.15
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$85.11 / $112.20 / $245.47
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$128.82 / $162.18 / $338.84
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$79.43 / $151.36 / $218.78
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $229.09
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$478.63 / $645.65 / $1,000.00
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $173.78 / $218.78
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$104.71 / $181.97 / $338.84
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$75.86 / $138.04 / $223.87
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$660.69 / $4,466.84 / $5,128.61
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$91.20 / $128.82 / $223.87