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New Jersey 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 $7,943 · 10th–90th $3,802–$13,1830%10%10th90th$7,943Professionalmedian $1,380 · 10th–90th $1,023–$3,7150%10%10th90th$1,380$200.0$500.0$1.0K$2.0K$5.0K$10.0K$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
$2,754.23 / $7,943.28 / $12,302.69
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,380.38 / $3,801.89
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $9,549.93 / $16,595.87
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,023.29 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,380.38 / $3,311.31
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,148.15 / $1,513.56
Horizon BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,128.31 / $12,882.50 / $20,417.38
Horizon BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,288.25 / $3,019.95
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,630.78 / $8,709.64 / $15,488.17
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$812.83 / $1,230.27 / $2,398.83