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Montana rates for HCPCS 67225

Destruction of localized lesion of choroid (eg, choroidal neovascularization); photodynamic therapy, second eye, at single session (List separately in addition to code for primary eye treatment)

Professionalmedian $42 · 10th–90th $29–$790%10%20%10th90th$42$50.0$100.0

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
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $39.81 / $95.50
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $31.62 / $45.71
MountainHealth Co-op
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$45.71 / $48.98 / $52.48
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.18 / $45.71 / $79.43
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$40.74 / $47.86 / $58.88