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Ohio rates for HCPCS 67221

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

Facilitymedian $2,239 · 10th–90th $324$10,2330%10%10th90th$2,239Professionalmedian $288 · 10th–90th $204$6170%20%10th90th$288$2.0$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$295.12 / $2,511.89 / $10,715.19
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $295.12 / $691.83
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $2,137.96 / $3,981.07
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $269.15 / $512.86
Aultcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $288.40
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$190.55 / $190.55 / $251.19
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $213.80 / $213.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $21,379.62
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$213.80 / $316.23 / $537.03
Medical Mutual of Ohio
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$154.88 / $154.88 / $21,379.62
Medical Mutual of Ohio
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $316.23 / $549.54
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
SummaCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $338.84
SummaCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$181.97 / $295.12 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$416.87 / $1,621.81 / $4,073.80
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $275.42 / $457.09