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West Virginia 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 $7,586 · 10th–90th $1,413–$12,5890%20%10th90th$7,586Professionalmedian $1,230 · 10th–90th $1,000–$2,1380%20%10th90th$1,230$50.0$200.0$1.0K$5.0K

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
$2,570.40 / $7,585.78 / $12,589.25
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,023.29 / $1,230.27 / $1,995.26
CareSource
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,174.90 / $1,174.90 / $1,380.38
CareSource
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,230.27 / $1,230.27 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$34.67 / $1,905.46 / $1,905.46
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
$1,023.29 / $1,698.24 / $6,165.95
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,772.37 / $14,454.40 / $16,982.44
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $1,737.80 / $1,819.70
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,548.13 / $3,548.13 / $11,481.54
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$891.25 / $1,288.25 / $2,041.74