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North Carolina 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 $7,244 · 10th–90th $1,778–$12,3030%10%10th90th$7,244Professionalmedian $1,622 · 10th–90th $1,096–$3,5480%10%10th90th$1,622$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
$1,778.28 / $7,244.36 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,513.56 / $3,235.94
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$912.01 / $1,000.00 / $1,949.84
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,412.54 / $1,659.59 / $3,548.13
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,621.81 / $2,884.03
Medcost
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,380.38 / $2,691.53
Medcost
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,819.70 / $1,819.70 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $12,022.64 / $19,498.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,412.54 / $2,951.21
Wellcare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $2,137.96 / $12,302.69
Wellcare
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
Wellcare
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $11,748.98