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South Dakota rates for HCPCS 67221

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

Facilitymedian $288 · 10th–90th $219–$4,3650%10%20%10th90th$288Professionalmedian $309 · 10th–90th $214–$5890%10%10th90th$309$200.0$500.0$1.0K$2.0K

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
$218.78 / $288.40 / $4,365.16
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$186.21 / $281.84 / $426.58
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$436.52 / $602.56 / $831.76
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$181.97 / $338.84 / $741.31
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$245.47 / $501.19 / $1,548.82
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$501.19 / $660.69 / $676.08
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$302.00 / $407.38 / $537.03
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,659.59 / $1,659.59
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$257.04 / $426.58 / $758.58
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $478.63 / $645.65