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Michigan 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 $5,495 · 10th–90th $1,622–$16,5960%10%10th90th$5,495Professionalmedian $1,479 · 10th–90th $1,072–$3,1620%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
$1,621.81 / $5,495.41 / $16,595.87
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,445.44 / $3,235.94
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,122.02 / $1,122.02
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,511.89 / $2,511.89 / $2,511.89
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,819.70 / $2,511.89
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,348.96 / $2,344.23
Health Alliance Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,621.81 / $5,495.41 / $12,589.25
Health Alliance Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,513.56 / $2,691.53
Priority Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,318.26 / $2,089.30
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $6,918.31 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,513.56 / $2,041.74