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Wyoming rates for HCPCS 67221

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

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$206.95 / $206.95 / $273.39
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$603.00 / $975.00 / $1,283.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$284.79 / $379.61 / $554.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$788.00 / $788.00 / $3,328.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$312.00 / $530.20 / $952.90