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California 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
$2,421.00 / $9,639.00 / $21,258.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,456.00 / $9,256.00 / $18,544.00
Blue Shield
Facility/Professional
Facility
Modifier
Low / Median / High Price
$66.00 / $100.00 / $8,938.65
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$705.31 / $2,977.65 / $4,058.71
Contra Costa Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$988.83 / $1,483.25 / $1,899.26
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,114.17 / $1,479.99 / $2,791.76
Lucent Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$55.00 / $7,614.32 / $11,879.05
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,254.23 / $1,639.15 / $2,623.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,416.00 / $12,341.00 / $26,451.00