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Missouri 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
$2,454.71 / $5,623.41 / $12,302.69
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,238.72 / $4,897.79 / $9,549.93
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,548.82 / $1,548.82 / $1,548.82
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$54.95 / $2,691.53 / $10,715.19
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,454.71 / $3,235.94 / $6,918.31