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Eye Surgery To Remove Fine Membrane From The Retina

Massachusetts rates for HCPCS 67042

This is a surgical procedure that removes the clear gel filling the eye and then carefully peels away a very thin layer of tissue from the surface of the retina, the light-sensing layer at the back of the eye. It is used to treat conditions such as a macular hole or swelling of the macula caused by diabetes that distorts central vision.

Rates data updated July 2026.

How much does Eye Surgery To Remove Fine Membrane From The Retina cost?

$5,229

Typical total for the visit. In Massachusetts, July 2026.

Insurers have agreed to pay about $5,229 for this procedure. That total is two separate charges: $1,514 to the doctor who performs it, and $3,715 to the hospital or surgery center where it takes place. Done somewhere without a facility charge, you pay only the first.

These are rates insurers have negotiated with providers, not the amount a patient is billed. What you owe depends on your plan's deductible and coinsurance. Based on rates published by 9 insurance carriers under federal price transparency rules.

What's inside this number

Part of the billTypicalRange
Physician feeThe doctor who performs it$1,514$1,148 to $2,399
Facility feeThe hospital or surgery center$3,715$2,818 to $5,495

How much rates vary

Facilitymedian $3,715 · 10th to 90th $1,318 to $7,943Professionalmedian $1,514 · 10th to 90th $1,096 to $3,890
$200$500$1K$2K$5K$10Kfacility $3,715professional $1,514

Distribution of negotiated rates across all payers (price axis is log-scale). Each curve is scaled to its own total: facility and professional rates are different services, shown together to compare where they cluster. Need provider-level prices or 24+ months of history? Contact us.

Rates by insurance carrier

Insurance Carrier
Aetna
Setting
Facility
Modifier
Global
Typical Low
$2,570.40
Median
$3,715.35
Typical High
$6,456.54
Aetna
Setting
Professional
Modifier
Global
Typical Low
$1,096.48
Median
$1,445.44
Typical High
$3,981.07
AllWays Health Partners
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$3,981.07
Typical High
$12,589.25
AllWays Health Partners
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,230.27
AllWays Health Partners
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,659.59
Typical High
$11,748.98
BCBS
Setting
Professional
Modifier
Global
Typical Low
$1,737.80
Median
$2,290.87
Typical High
$3,019.95
Cigna
Setting
Professional
Modifier
Global
Typical Low
$1,047.13
Median
$1,995.26
Typical High
$3,630.78
Fallon Health
Setting
Facility
Modifier
Global
Typical Low
$1,000.00
Median
$1,412.54
Typical High
$5,248.07
Fallon Health
Setting
Professional
Modifier
Global
Typical Low
$1,071.52
Median
$1,258.93
Typical High
$1,621.81
Harvard Pilgrim
Setting
Facility
Modifier
Global
Typical Low
$2,511.89
Median
$6,165.95
Typical High
$13,182.57
Harvard Pilgrim
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,698.24
Typical High
$3,162.28
Health New England
Setting
Facility
Modifier
Global
Typical Low
$2,041.74
Median
$2,187.76
Typical High
$5,248.07
Health New England
Setting
Professional
Modifier
Global
Typical Low
$1,584.89
Median
$1,778.28
Typical High
$4,168.69
Mass General Brigham
Setting
Facility
Modifier
Global
Typical Low
$2,137.96
Median
$3,981.07
Typical High
$12,589.25
Mass General Brigham
Setting
Facility
Modifier
AS · PA/NP assist
Typical Low
$1,230.27
Median
$1,230.27
Typical High
$1,230.27
Mass General Brigham
Setting
Professional
Modifier
Global
Typical Low
$977.24
Median
$1,659.59
Typical High
$11,748.98
United
Setting
Facility
Modifier
Global
Typical Low
$2,344.23
Median
$6,165.95
Typical High
$13,182.57
United
Setting
Professional
Modifier
Global
Typical Low
$1,148.15
Median
$1,949.84
Typical High
$3,890.45

Where Massachusetts sits

The same service costs 5.7 times more in Maine than in Montana. Every bar is a state, most expensive first. Touch or drag across it to read any state, then open that state for its carriers and full range.

Physician feeFacility fee

Massachusetts· 44th of 50

$5,229

$1,514 physician + $3,715 facility

ME $18,791MT $3,314

Median negotiated rate in each state, from every insurer that publishes one. States where no insurer publishes a rate for this service are not shown.