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Wisconsin 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
$25.70 / $30.90 / $52.48
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$28.84 / $52.48 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $66.07 / $134.90
DeanCare
Facility/Professional
Professional
Modifier
Low / Median / High Price
$51.29 / $72.44 / $85.11
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$30.90 / $66.07 / $794.33
Molina
Facility/Professional
Professional
Modifier
Low / Median / High Price
$32.36 / $33.11 / $70.79
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$34.67 / $66.07 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$29.51 / $104.71 / $794.33
Security Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$128.82 / $263.03 / $281.84
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$27.54 / $48.98 / $123.03