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Mississippi rates for HCPCS 67221

Dstrj Lesion Choroid Photodynamic Therapy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$273.62 / $784.00 / $1,831.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$183.62 / $260.24 / $631.80
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$198.93 / $198.93 / $198.93
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$688.00 / $688.00 / $688.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$155.93 / $172.39 / $771.45
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.91 / $331.05 / $573.89
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.34 / $32.34 / $32.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$455.00 / $825.00 / $1,957.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$258.54 / $324.48 / $618.60