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South Carolina rates for HCPCS 67221

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

Facilitymedian $2,239 · 10th–90th $288–$9,7720%5%10th90th$2,239Professionalmedian $295 · 10th–90th $200–$5130%10%20%10th90th$295$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
$338.84 / $4,897.79 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $309.03 / $524.81
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $1,288.25 / $2,398.83
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$169.82 / $295.12 / $524.81
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$245.47 / $245.47 / $245.47
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$229.09 / $323.59 / $524.81
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$229.09 / $338.84 / $616.60
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$436.52 / $3,090.30 / $7,762.47
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $269.15 / $457.09