go back

Illinois 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 $5,623 · 10th–90th $1,660–$15,4880%5%10th90th$5,623Professionalmedian $1,660 · 10th–90th $1,148–$5,1290%10%10th90th$1,660$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
$1,621.81 / $5,623.41 / $15,488.17
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,659.59 / $5,248.07
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,023.29
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,370.32 / $6,456.54 / $23,988.33
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,819.70 / $1,995.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,621.81 / $2,454.71
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,949.84 / $6,606.93
Hally Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$100.00 / $100.00 / $100.00
Hally Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,380.38 / $1,479.11
Molina
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$32.36 / $32.36 / $33.11
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,019.95 / $5,370.32 / $12,022.64
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,659.59 / $2,511.89