| Insurance Carrier | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,215.17 | $1,215.17 | $10,000.00 | |
Medica
| Facility | $1,215.17 | $1,702.03 | $3,645.51 | |
United
| Facility | $4,640.00 | $4,640.00 | $4,640.00 |
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 | Facility/Professional | Modifier | Low Price | Median Price | High Price |
|---|---|---|---|---|---|
Aetna
| Facility | $1,215.17 | $1,215.17 | $10,000.00 | |
Medica
| Facility | $1,215.17 | $1,702.03 | $3,645.51 | |
United
| Facility | $4,640.00 | $4,640.00 | $4,640.00 |