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California rates for HCPCS 67221

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

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$277.08 / $4,704.00 / $16,109.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$184.74 / $253.91 / $650.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,097.00 / $5,694.00 / $11,233.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$148.44 / $328.44 / $712.40
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $5,021.77
Blue Shield
Facility/Professional
Professional
Modifier
Low / Median / High Price
$185.26 / $264.66 / $610.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$214.30 / $292.11 / $555.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$212.00 / $314.29 / $624.01
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$237.76 / $320.98 / $440.95
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$204.67 / $299.24 / $551.00
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $1,649.69 / $1,690.08
Lucent Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,511.20 / $2,025.28 / $2,318.03
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.44 / $328.29 / $481.22
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$214.72 / $340.73 / $692.28
Sutter Health Plus
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.38 / $691.38 / $924.60
The Alliance
Facility/Professional
Professional
Modifier
Low / Median / High Price
$216.14 / $367.15 / $550.72
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,046.00 / $2,699.00 / $7,655.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$222.88 / $286.56 / $697.72