Intravitreal eye injection of medication

Hospitals report these codes with terse, inconsistent chargemaster text. This plain-English title was written by an AI model from that text and has not been reviewed by a person, so it can be wrong. The prices on this page come straight from hospital filings and do not depend on it.

Model: claude-haiku-5-5
Provider: anthropic
API: message_batches
Reasoning effort: low
Max output tokens: 4096
Prompt version (hash): 444523875572
Generated: October 20, 2026

Original text from hospital filings

HC INTRAVITREAL INJECTION

Payers reporting CPT 67028

Payer pricing summary

Low

$107

Average

$951

Median

$629

High

$6.4k

Payer rate distribution

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#
1	Aetna fee schedule · outpatient · +34 other terms	498	$369	$1.1k	$2.0k	185%	3–30	$1 – $21.3k
2	UnitedHealthcare fee schedule · outpatient · +33 other terms	553	$333	$688	$1.3k	191%	—	$1 – $17.9k
3	Humana fee schedule · outpatient · +27 other terms	377	$327	$416	$865	208%	—	$1 – $12.8k
4	Blue Cross Blue Shield fee schedule · outpatient · +29 other terms	364	$446	$934	$1.7k	186%	—	$0 – $18.0k
5	Cigna case rate · outpatient · +30 other terms	334	$3.1k	$4.6k	$6.1k	133%	—	$1 – $40.7k
6	Molina fee schedule · outpatient · +25 other terms	216	$251	$206	$250	121%	—	$1 – $1.7k
7	WellCare fee schedule · outpatient · +19 other terms	191	$336	$389	$461	118%	—	$45 – $4.3k
8	Oscar case rate · outpatient · +20 other terms	136	$2.6k	$2.7k	$680	25%	—	$519 – $7.5k
9	Anthem case rate · outpatient · +26 other terms	122	$2.5k	$2.9k	$1.6k	53%	—	$300 – $11.2k
10	Kaiser fee schedule · outpatient · +21 other terms	101	$470	$657	$674	102%	—	$45 – $4.3k
11	Ambetter facility · fee schedule · outpatient · +17 other terms	86	$607	$730	$914	125%	—	$150 – $8.2k
12	Aetna Better Health fee schedule · outpatient · +19 other terms	73	$61	$91	$74	82%	—	$53 – $370
13	Devoted fee schedule · outpatient · +13 other terms	70	$337	$309	$83	27%	—	$89 – $375
14	Caresource fee schedule · outpatient · +14 other terms	59	$319	$354	$494	139%	—	$1 – $4.3k
15	Optum fee schedule · outpatient · +22 other terms	57	$304	$340	$205	60%	—	$82 – $1.2k
16	Superior Healthplan case rate · outpatient · +4 other terms	46	$2.4k	$2.3k	$288	12%	—	$498 – $2.4k
17	Healthcare Highways case rate · outpatient · +3 other terms	42	$5.8k	$6.6k	$5.1k	78%	—	$2.1k – $14.6k
18	MultiPlan fee schedule · outpatient · +20 other terms	37	$528	$529	$76	14%	—	$53 – $983
19	Cigna Healthspring fee schedule · outpatient · +9 other terms	33	$82	$208	$137	66%	—	$51 – $352
20	Clover fee schedule · outpatient · +9 other terms	31	$370	$879	$1.3k	148%	—	$298 – $4.4k
21	Amerihealth Caritas case rate · outpatient · +11 other terms	30	$370	$1.6k	$1.4k	87%	—	$196 – $3.3k
22	First Health fee schedule · outpatient · +17 other terms	30	$345	$1.2k	$2.3k	200%	—	$48 – $7.2k
23	Tricare fee schedule · outpatient · +17 other terms	29	$300	$969	$1.7k	173%	—	$91 – $5.1k
24	Bcbs Tx fee schedule · outpatient · +2 other terms	28	$112	$101	$87	85%	—	$37 – $336
25	Medica case rate · outpatient · +19 other terms	28	$859	$925	$739	80%	—	$128 – $4.5k

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