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Wisconsin 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 $10,233 · 10th–90th $5,012–$16,9820%5%10%10th90th$10,233Professionalmedian $2,399 · 10th–90th $1,122–$3,6310%10%10th90th$2,399$1.0K$2.0K$5.0K$10.0K$20.0K

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
$1,778.28 / $5,754.40 / $13,489.63
Anthem BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,964.78 / $18,197.01
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,162.28 / $3,715.35 / $5,888.44
DeanCare
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $4,677.35 / $9,549.93
Medica
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,318.26 / $7,244.36 / $15,848.93
Network Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,311.31 / $9,332.54 / $15,848.93
Quartz
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $2,398.83 / $3,630.78
Quartz
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$8,128.31 / $11,748.98 / $11,748.98
Security Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$5,623.41 / $5,623.41 / $5,623.41
Security Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $6,606.93 / $6,606.93
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$7,585.78 / $12,022.64 / $14,454.40