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Arizona rates for HCPCS 67221

Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy (includes intravenous infusion)

Facilitymedian $2,399 · 10th–90th $661–$5,6230%10%10th90th$2,399Professionalmedian $275 · 10th–90th $191–$6170%10%10th90th$275$100.0$200.0$500.0$1.0K$2.0K$5.0K

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
$1,445.44 / $3,090.30 / $6,309.57
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $275.42 / $616.60
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $2,454.71 / $4,570.88
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $257.04 / $1,348.96
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$151.36 / $151.36 / $151.36
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $263.03 / $524.81
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$213.80 / $354.81 / $2,630.27
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $331.13 / $2,041.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$467.74 / $1,230.27 / $3,235.94
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $251.19 / $407.38