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Maryland 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
$7,238.70 / $7,238.70 / $7,238.70
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,274.00 / $1,349.24 / $2,078.94
Kaiser Permanente
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,220.69 / $1,403.79 / $1,831.04
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,118.00 / $2,118.00 / $2,118.00