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Pennsylvania rates for HCPCS 67221

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

Facilitymedian $2,692 · 10th–90th $661–$8,3180%5%10%10th90th$2,692Professionalmedian $263 · 10th–90th $200–$4900%20%10th90th$263$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
$724.44 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $263.03 / $501.19
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $2,570.40 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$275.42 / $288.40 / $512.86
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$354.81 / $354.81 / $354.81
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$190.55 / $288.40 / $478.63
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$346.74 / $346.74 / $478.63
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$239.88 / $316.23 / $478.63
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,511.89
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$316.23 / $346.74 / $416.87
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$537.03 / $1,995.26 / $7,244.36
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$194.98 / $263.03 / $501.19
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $416.87 / $676.08
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$263.03 / $295.12 / $389.05
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $295.12 / $467.74
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$549.54 / $1,318.26 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $275.42 / $467.74