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Oklahoma 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
$625.00 / $2,876.00 / $7,500.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$226.42 / $279.30 / $296.29
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$847.51 / $1,336.76 / $2,127.26
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.50 / $273.94 / $359.97
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$157.22 / $157.22 / $157.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$192.75 / $296.51 / $464.32
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$226.42 / $389.72 / $2,704.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.92 / $288.12 / $1,548.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$352.00 / $1,279.00 / $2,637.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$229.82 / $285.39 / $359.09