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Idaho 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 $4,677 · 10th–90th $2,692–$10,9650%10%10th90th$4,677Professionalmedian $1,585 · 10th–90th $1,175–$3,2360%10%20%10th90th$1,585$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
$2,884.03 / $4,365.16 / $5,495.41
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,548.82 / $3,235.94
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $5,370.32 / $10,964.78
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $2,137.96 / $2,290.87
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,659.59 / $2,041.74
Moda Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $2,511.89 / $4,466.84
Moda Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,659.59 / $2,570.40
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,413.10 / $9,120.11 / $13,803.84
Regence BlueShield
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,238.72 / $2,398.83
Select Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,995.26 / $5,495.41
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,995.26 / $22,387.21 / $27,542.29
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,698.24 / $2,570.40