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Tennessee 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 $4,365 · 10th–90th $1,230–$8,3180%5%10%10th90th$4,365Professionalmedian $1,549 · 10th–90th $1,072–$5,1290%10%10th90th$1,549$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
$1,071.52 / $4,073.80 / $7,585.78
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,548.82 / $5,128.61
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $891.25 / $891.25
BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $4,365.16 / $6,165.95
BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,659.59 / $2,818.38
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,584.89 / $2,290.87
Lucent Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,137.96 / $12,302.69 / $12,302.69
Lucent Health
Facility/Professional
Facility
Modifier
AS
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
Lucent Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$11,748.98 / $11,748.98 / $11,748.98
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,467.37 / $5,754.40 / $10,232.93
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,047.13 / $1,412.54 / $2,290.87