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Maryland rates for HCPCS 67141

Prophylaxis of retinal detachment (eg, retinal break, lattice degeneration) without drainage; cryotherapy, diathermy

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.36 / $349.49 / $462.02
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$232.18 / $232.45 / $535.37
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$135.09 / $158.93 / $449.41
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$207.29 / $435.48 / $781.19
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$261.58 / $316.66 / $445.31
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$89.00 / $89.00 / $89.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$387.56 / $493.33 / $917.99
Wellpoint
Facility/Professional
Professional
Modifier
Low / Median / High Price
$231.42 / $275.36 / $316.66