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Hawaii 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 $6,026 · 10th–90th $2,570–$6,0260%50%10th$6,026Professionalmedian $1,549 · 10th–90th $1,148–$8,9130%10%10th90th$1,549$50.0$200.0$1.0K$5.0K

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
$2,570.40 / $6,025.60 / $6,025.60
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,380.38 / $2,187.76
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,445.44 / $1,737.80
HMSA
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,290.87 / $14,791.08
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,174.90 / $1,380.38
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,884.03 / $2,884.03 / $2,884.03
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,479.11 / $1,862.09
University Health Alliance
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,380.38 / $6,918.31 / $10,232.93