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Indiana rates for HCPCS 67221

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

Facilitymedian $4,365 · 10th–90th $676–$8,3180%10%10th90th$4,365Professionalmedian $275 · 10th–90th $200–$5250%10%10th90th$275$100.0$200.0$500.0$1.0K$2.0K$5.0K$10.0K

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
$275.42 / $3,801.89 / $5,623.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $288.40 / $562.34
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $4,466.84 / $8,709.64
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$173.78 / $204.17 / $371.54
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$208.93 / $208.93 / $208.93
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$186.21 / $354.81 / $446.68
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $288.40 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$457.09 / $2,818.38 / $4,265.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$204.17 / $288.40 / $467.74