| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,474.42 | $13,413.92 | $20,143.00 | |
Moda Health
| Facility | $1,456.69 | $1,742.80 | $9,542.87 | |
Providence
| Facility | $1,742.80 | $1,742.80 | $9,542.87 |
Vitrectomy, mechanical, pars plana approach; with removal of subretinal membrane (eg, choroidal neovascularization), includes, if performed, intraocular tamponade (ie, air, gas or silicone oil) and laser photocoagulation
| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $3,474.42 | $13,413.92 | $20,143.00 | |
Moda Health
| Facility | $1,456.69 | $1,742.80 | $9,542.87 | |
Providence
| Facility | $1,742.80 | $1,742.80 | $9,542.87 |