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Minnesota 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 $6,918 · 10th–90th $1,995–$14,7910%5%10%10th90th$6,918Professionalmedian $1,950 · 10th–90th $1,175–$3,8900%10%10th90th$1,950$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
$1,202.26 / $9,120.11 / $13,489.63
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,318.26 / $2,818.38
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,248.07 / $9,549.93 / $25,118.86
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $2,398.83 / $4,073.80
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,951.21 / $4,168.69 / $10,000.00
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,995.26 / $3,162.28 / $5,011.87
Health Partners
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,235.94 / $3,981.07 / $7,943.28
Health Partners
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,949.84 / $2,818.38 / $4,466.84
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $2,344.23 / $10,471.29
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,174.90 / $2,089.30 / $8,317.64
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $9,120.11 / $11,748.98
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,187.76 / $4,570.88