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Maryland 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 $3,311 · 10th–90th $1–$5,7540%20%10th90th$3,311Professionalmedian $1,445 · 10th–90th $1,096–$3,8020%20%10th90th$1,445$1.0$5.0$20.0$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
$1.00 / $3,311.31 / $5,754.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,479.11 / $3,890.45
CareFirst
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,174.90 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,348.96 / $2,089.30
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,258.93 / $2,238.72
Kaiser Permanente
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$954.99 / $1,096.48 / $1,584.89
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $8,511.38
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,230.27 / $2,290.87
Wellpoint
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,047.13 / $1,513.56