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South Dakota 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)

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $33.11 / $91.20
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$47.86 / $67.61 / $85.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$26.30 / $53.70 / $794.33
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.10 / $66.07 / $69.18
Sanford Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $48.98 / $57.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.18 / $50.12 / $79.43
Wellmark
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $63.10 / $67.61