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Rhode Island rates for HCPCS 67221

Dstrj Lesion Choroid Photodynamic Therapy

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,518.41 / $1,543.03 / $3,955.04
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$169.21 / $246.07 / $330.02
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$244.97 / $334.09 / $415.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$170.57 / $293.00 / $572.70
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,388.00 / $2,517.00 / $4,602.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$200.71 / $344.37 / $448.16