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Missouri 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 $4,898 · 10th–90th $1,950–$10,0000%5%10th90th$4,898Professionalmedian $1,380 · 10th–90th $1,096–$2,7540%10%20%10th90th$1,380$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
$1,698.24 / $5,623.41 / $11,481.54
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,380.38 / $2,818.38
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,238.72 / $4,897.79 / $9,549.93
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,380.38 / $2,290.87
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,071.52 / $1,995.26
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,548.82 / $1,548.82 / $2,344.23
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$446.68 / $1,584.89 / $2,818.38
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,258.93 / $2,570.40 / $10,715.19
Medica
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$295.12 / $1,122.02 / $1,122.02
Medica
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,548.82 / $11,220.18
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,454.71 / $3,311.31 / $6,606.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,412.54 / $2,137.96