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Indiana 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 $15,488 · 10th–90th $2,239–$25,7040%5%10%10th90th$15,488Professionalmedian $1,479 · 10th–90th $1,072–$2,8180%10%10th90th$1,479$100.0$500.0$2.0K$10.0K

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
$1,862.09 / $10,471.29 / $19,952.62
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,445.44 / $2,818.38
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,023.29 / $1,348.96
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,570.88 / $18,197.01 / $26,302.68
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,202.26 / $1,584.89 / $2,344.23
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$891.25 / $1,513.56 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,380.38 / $1,995.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,691.53 / $9,549.93 / $18,197.01
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,380.38 / $2,344.23