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Pennsylvania rates for HCPCS 67500

Retrobulbar injection; medication (separate procedure, does not include supply of medication)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.73 / $2,747.00 / $8,113.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.47 / $74.47 / $96.71
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,083.51 / $1,395.00 / $12,759.45
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$76.06 / $78.93 / $144.97
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.08 / $78.92 / $137.88
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$90.74 / $90.74 / $117.01
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$299.70 / $299.70 / $299.70
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$93.49 / $93.49 / $93.49
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$594.00 / $4,264.00 / $8,247.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$61.47 / $78.84 / $383.46
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$124.60 / $124.60 / $124.60
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$57.40 / $78.04 / $132.01
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$62.03 / $68.98 / $75.20
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.03 / $72.62 / $78.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.00 / $674.00 / $4,300.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$67.26 / $83.67 / $139.03