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Utah 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

Facilitymedian $6,026 · 10th–90th $3,162–$12,0230%10%10th90th$6,026Professionalmedian $1,820 · 10th–90th $1,445–$2,6300%20%10th90th$1,820$1.0K$2.0K$5.0K$10.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $6,025.60 / $10,232.93
Regence BlueShield
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,754.40 / $7,943.28 / $12,022.64
U of Utah Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,819.70 / $2,630.27
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,202.26 / $5,128.61 / $13,803.84