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Indiana 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
$1,123.66 / $2,887.81 / $17,225.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,174.00 / $10,288.00 / $26,304.00
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,087.74 / $1,456.22 / $2,202.67
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$450.00 / $1,336.33 / $2,806.76
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,529.00 / $9,550.00 / $15,750.00