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California rates for HCPCS 67042

Vitrectomy, mechanical, pars plana approach; with removal of internal limiting membrane of retina (eg, for repair of macular hole, diabetic macular edema), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil)

Facilitymedian $10,471 · 10th–90th $3,802$19,9530%10%10th90th$10,471Professionalmedian $1,380 · 10th–90th $1,175$4,1690%20%10th90th$1,380$50.0$200.0$1.0K$5.0K$20.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,168.69 / $10,964.78 / $26,915.35
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,380.38 / $4,168.69
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $912.01 / $1,023.29
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,025.60 / $10,471.29 / $17,782.79
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,548.82 / $2,089.30 / $4,168.69
Blue Shield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $6,165.95 / $11,220.18
Blue Shield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,621.81 / $3,801.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$707.95 / $2,951.21 / $4,073.80
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,584.89 / $3,090.30
Contra Costa Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,258.93 / $1,778.28
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,174.90 / $2,344.23
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $12,302.69
Lucent Health
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $11,748.98
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,584.89
Providence
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,412.54 / $2,630.27
Providence
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,621.81 / $3,162.28
Sutter Health Plus
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$3,801.89 / $3,801.89 / $3,801.89
The Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,318.26 / $1,995.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $11,220.18 / $25,118.86
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,288.25 / $2,884.03