go back

Wisconsin rates for HCPCS 67107

Repair of retinal detachment; scleral buckling (such as lamellar scleral dissection, imbrication or encircling procedure), including, when performed, implant, cryotherapy, photocoagulation, and drainage of subretinal fluid

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,659.59 / $9,332.54 / $9,332.54
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $10,964.78 / $18,197.01
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,951.21 / $3,467.37 / $5,495.41
DeanCare
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $4,168.69 / $7,413.10
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $5,248.07 / $15,135.61
Quartz
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,047.13 / $2,238.72 / $3,388.44
Quartz
Facility/Professional
Facility
Modifier
Low / Median / High Price
$8,128.31 / $11,748.98 / $11,748.98
Security Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,606.93 / $6,606.93 / $6,606.93
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,585.78 / $12,022.64 / $16,218.10