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Virginia 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
$52.54 / $3,633.00 / $8,920.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$52.54 / $64.91 / $96.71
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,735.00 / $2,390.00 / $2,954.00
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$58.69 / $75.06 / $104.22
CareFirst
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.40 / $156.72 / $2,413.00
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$109.59 / $109.59 / $109.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$62.53 / $87.59 / $137.29
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$70.93 / $83.45 / $108.26
Medcost
Facility/Professional
Facility
Modifier
Low / Median / High Price
$61.30 / $83.63 / $127.47
Medcost
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.00 / $113.00 / $144.40
Sentara
Facility/Professional
Facility
Modifier
Low / Median / High Price
$46.67 / $86.41 / $1,380.00
Sentara
Facility/Professional
Professional
Modifier
Low / Median / High Price
$63.14 / $96.88 / $1,380.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$296.00 / $1,045.00 / $2,364.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$53.37 / $68.20 / $119.73