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Washington rates for HCPCS 67028

Intravitreal injection of a pharmacologic agent (separate procedure)

Facilitymedian $295 · 10th–90th $135$7,9430%10%10th90th$295Professionalmedian $158 · 10th–90th $72$6170%10%10th90th$158$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$199.53 / $954.99 / $10,232.93
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$676.08 / $1,318.26 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$64.57 / $128.82 / $489.78
Aetna
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$158.49 / $218.78 / $870.96
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$154.88 / $158.49 / $239.88
Ambetter
Facility/Professional
Professional
Modifier
50
Typical Low / Median / Typical High
$229.09 / $239.88 / $363.08
Asuris Northwest Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $912.01 / $1,819.70
Asuris Northwest Health
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,023.29
Asuris Northwest Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $213.80 / $302.00
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$138.04 / $138.04 / $478.63
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $194.98 / $346.74
Kaiser Permanente
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$77.62 / $173.78 / $281.84
Kaiser Permanente
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$912.01 / $1,479.11 / $2,630.27
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$77.62 / $181.97 / $269.15
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $72.44
Pacific Source
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$169.82 / $213.80 / $229.09
Premera BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$147.91 / $147.91 / $154.88
Premera BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$123.03 / $190.55 / $281.84
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $933.25 / $1,819.70
Regence BlueShield
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$794.33 / $794.33 / $1,023.29
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$151.36 / $218.78 / $302.00
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$141.25 / $1,047.13 / $2,238.72
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$120.23 / $169.82 / $275.42
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
$79.43 / $134.90 / $245.47