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North Dakota 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
$212.24 / $282.25 / $8,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$175.55 / $229.56 / $302.29
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$405.69 / $523.29 / $648.25
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$223.66 / $419.42 / $701.28
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$212.24 / $351.65 / $586.40
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$287.27 / $517.23 / $1,548.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$676.00 / $676.00 / $676.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$272.95 / $438.40 / $666.01