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Arizona rates for HCPCS 67043

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
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,965.00 / $4,521.00 / $9,112.00
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,310.70 / $5,094.77 / $8,070.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,399.00 / $1,399.00 / $1,399.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,224.50 / $4,759.00 / $8,135.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,500.00 / $6,455.00 / $9,010.00