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Nebraska 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
$5,417.02 / $11,611.47 / $24,068.03
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,949.08 / $7,762.05 / $15,135.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,141.50 / $3,141.50 / $3,141.50
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,123.66 / $2,643.47 / $8,816.00
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,246.29 / $3,141.50 / $4,188.66
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,178.00 / $7,441.00 / $8,816.00