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North Dakota 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
$1,215.17 / $1,215.17 / $10,000.00
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,215.17 / $1,702.03 / $3,645.51
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,640.00 / $4,640.00 / $4,640.00