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Utah rates for HCPCS 67039

Vitrectomy, mechanical, pars plana approach; with focal endolaser photocoagulation

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,818.38 / $4,570.88 / $10,232.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,456.54 / $7,585.78 / $16,982.44
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,174.90 / $1,445.44 / $2,754.23
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,884.03 / $5,128.61 / $13,803.84