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New York 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
$1,654.00 / $5,700.00 / $12,466.00
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,046.00 / $7,264.00 / $12,538.00
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,687.48 / $3,478.50 / $13,477.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,336.33 / $1,336.33 / $2,907.52
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$332.00 / $1,473.00 / $3,013.45
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$555.00 / $1,336.33 / $74,999.25
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,264.00 / $5,731.00 / $12,509.00
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,628.39 / $1,628.39 / $4,490.03