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Wyoming rates for HCPCS 67028

Intravitreal injection of a pharmacologic agent (separate procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$912.01 / $912.01 / $912.01
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$85.11 / $120.23 / $309.03
Aetna
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$154.88 / $295.12 / $389.05
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$316.23 / $512.86 / $537.03
BCBS
Facility/Professional
Professional
Modifier
50
Low / Median / High Price
$263.03 / $478.63 / $794.33
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.71 / $141.25 / $199.53
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$281.84 / $295.12 / $3,090.30
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.18 / $218.78 / $562.34