Photodynamic therapy for choroid lesions in the eye

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 DEST LOC LES CHOROID, PHOTODYN >=1 SESSION

Payers reporting CPT 67221

Payer pricing summary

Low

$240

Average

$1.2k

Median

$932

High

$5.9k

Payer rate distribution

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#
1	UnitedHealthcare fee schedule · outpatient · +30 other terms	494	$554	$1.2k	$1.6k	138%	—	$1 – $17.9k
2	Aetna fee schedule · outpatient · +29 other terms	440	$635	$1.5k	$2.2k	145%	—	$1 – $21.3k
3	Humana fee schedule · outpatient · +25 other terms	346	$535	$635	$878	138%	—	$1 – $12.8k
4	Blue Cross Blue Shield fee schedule · outpatient · +24 other terms	329	$1.1k	$1.6k	$1.9k	122%	—	$0 – $18.0k
5	Cigna case rate · outpatient · +20 other terms	318	$3.0k	$6.1k	$9.0k	148%	—	$1 – $54.4k
6	Molina fee schedule · outpatient · +22 other terms	217	$431	$339	$340	100%	—	$1 – $2.3k
7	WellCare fee schedule · outpatient · +13 other terms	161	$549	$645	$560	87%	—	$123 – $4.3k
8	Oscar case rate · outpatient · +17 other terms	130	$3.0k	$2.4k	$1.1k	45%	—	$858 – $7.5k
9	Anthem fee schedule · outpatient · +21 other terms	124	$573	$741	$866	117%	—	$142 – $6.3k
10	Kaiser fee schedule · outpatient · +14 other terms	95	$754	$1.0k	$833	81%	—	$184 – $4.3k
11	Healthcare Highways case rate · outpatient · +1 other terms	76	$2.2k	$1.9k	$569	30%	—	$1.2k – $3.4k
12	Aetna Better Health fee schedule · outpatient · +15 other terms	70	$148	$175	$77	44%	—	$129 – $514
13	Ambetter facility · fee schedule · outpatient · +11 other terms	69	$983	$1.5k	$2.0k	136%	—	$380 – $14.7k
14	Devoted fee schedule · outpatient · +9 other terms	67	$556	$521	$119	23%	—	$199 – $620
15	Optum fee schedule · outpatient · +19 other terms	52	$503	$593	$383	65%	—	$190 – $2.0k
16	Superior Healthplan case rate · outpatient · +5 other terms	46	$2.4k	$2.3k	$238	10%	—	$824 – $2.4k
17	Caresource fee schedule · outpatient · +11 other terms	38	$545	$646	$1.1k	164%	—	$1 – $4.3k
18	Bcbs Tx fee schedule · outpatient · +2 other terms	33	$284	$268	$139	52%	—	$117 – $635
19	Clover fee schedule · outpatient · +7 other terms	29	$613	$1.1k	$1.3k	112%	—	$532 – $4.4k
20	Cigna Healthspring fee schedule · outpatient · +7 other terms	28	$123	$319	$210	66%	—	$123 – $576
21	Medica case rate · outpatient · +15 other terms	28	$1.8k	$2.0k	$1.1k	54%	—	$519 – $4.5k
22	Tricare fee schedule · outpatient · +12 other terms	28	$499	$1.2k	$1.7k	141%	—	$195 – $5.1k
23	Bcbs La fee schedule · outpatient · +1 other terms	25	$1.1k	$1.1k	$378	34%	—	$148 – $1.7k
24	Medicare fee schedule · outpatient · +10 other terms	25	$199	$833	$1.3k	161%	—	$184 – $4.2k
25	MultiPlan fee schedule · outpatient · +18 other terms	22	$932	$926	$39	4%	—	$515 – $951

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