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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)

Professionalmedian $36 · 10th–90th $26–$1050%10%20%10th90th$36$20.0$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
$25.70 / $30.90 / $56.23
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$28.84 / $52.48 / $144.54
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.11 / $67.61 / $134.90
DeanCare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$51.29 / $72.44 / $85.11
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$30.90 / $64.57 / $794.33
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $33.11 / $70.79
Network Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$39.81 / $85.11 / $125.89
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$33.88 / $66.07 / $100.00
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$43.65 / $131.83 / $794.33
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $128.82 / $138.04
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$128.82 / $263.03 / $281.84
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$26.92 / $48.98 / $120.23