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New York 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 $6,026 · 10th–90th $1,622$12,5890%10%10th90th$6,026Professionalmedian $1,380 · 10th–90th $1,023$3,2360%20%10th90th$1,380$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
$1,548.82 / $5,623.41 / $12,022.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,380.38 / $3,235.94
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $7,762.47 / $13,803.84
Anthem BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$977.24 / $1,258.93 / $3,311.31
CDPHP
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,584.89 / $3,467.37 / $13,489.63
CDPHP
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,584.89 / $1,584.89 / $1,584.89
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $2,884.03 / $53,703.18
Cigna
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$190.55 / $190.55 / $190.55
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,659.59 / $5,248.07
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,096.48 / $1,479.11 / $3,630.78
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,318.26 / $1,995.26
Excellus BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$776.25 / $1,412.54 / $2,398.83
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,890.45 / $7,762.47 / $8,317.64
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,380.38 / $1,548.82
MVP Health Care
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,380.38 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $1,412.54 / $2,454.71
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,398.83 / $5,495.41 / $12,302.69
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$933.25 / $1,380.38 / $3,162.28
Univera
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$933.25 / $1,548.82 / $4,265.80
Univera
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,412.54 / $3,890.45