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Georgia 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 $5,129 · 10th–90th $1,862–$9,5500%10%10th90th$5,129Professionalmedian $1,549 · 10th–90th $1,096–$2,8180%10%10th90th$1,549$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
$2,630.27 / $5,495.41 / $9,549.93
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,513.56 / $2,951.21
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,380.38 / $2,344.23
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $4,168.69 / $9,549.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,659.59 / $2,454.71
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $5,011.87 / $9,772.37
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,862.09 / $2,951.21
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,348.96 / $6,025.60
Kaiser Permanente
Facility/Professional
Professional
Modifier
80
Typical Low / Median / Typical High
$77.62 / $77.62 / $120.23
Kaiser Permanente
Facility/Professional
Professional
Modifier
AS
Typical Low / Median / Typical High
$38.90 / $38.90 / $60.26
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,995.26 / $4,570.88
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,513.56 / $6,165.95 / $10,715.19
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,659.59 / $2,691.53