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Eye Surgery To Remove Fine Membrane From The Retina

Washington, DC rates for HCPCS 67042

This is a surgical procedure that removes the clear gel filling the eye and then carefully peels away a very thin layer of tissue from the surface of the retina, the light-sensing layer at the back of the eye. It is used to treat conditions such as a macular hole or swelling of the macula caused by diabetes that distorts central vision.

Rates data updated July 2026.

How much does Eye Surgery To Remove Fine Membrane From The Retina cost?

$1,445

Typical physician fee. In Washington, DC, July 2026.

Insurers have agreed to pay about $1,445 for this service. Most negotiated rates run $1,230 to $4,074.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 5 insurance carriers under federal price transparency rules.

How much rates vary

Facilitymedian $5,495 · 10th to 90th $1,445 to $7,762Professionalmedian $1,349 · 10th to 90th $245 to $2,239
$500$1K$2K$5K$10K$20Kfacility $5,495professional $1,349

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$1,445.44
Median
$5,495.41
Typical High
$7,762.47
Aetna
Setting
Professional
Modifier
Global
Typical Low
$245.47
Median
$1,348.96
Typical High
$1,445.44
CareFirst
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$3,630.78
Typical High
$7,943.28
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,584.89
Typical High
$3,388.44
Kaiser Permanente
Setting
Professional
Modifier
Global
Typical Low
$1,000.00
Median
$1,174.90
Typical High
$2,570.40
United
Setting
Facility
Modifier
Global
Typical Low
$4,073.80
Median
$13,182.57
Typical High
$29,512.09
United
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,380.38
Typical High
$7,762.47

Where Washington, DC sits

The same service costs 4.8 times more in Wyoming than in Delaware. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Washington, DC· 45th of 51

$1,445

WY $6,166DE $1,288

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.