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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)

Professionalmedian $40 · 10th–90th $28–$680%20%10th90th$40$50.0$100.0$200.0$500.0

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
$25.12 / $30.20 / $47.86
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$56.23 / $67.61 / $85.11
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.30 / $53.70 / $512.86
Midlands
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$66.07 / $69.18 / $70.79
Sanford Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $48.98 / $57.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$27.54 / $52.48 / $79.43
Wellmark
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $63.10 / $67.61