go back

Maine rates for HCPCS 67108

Repair of retinal detachment; with vitrectomy, any method, including, when performed, air or gas tamponade, focal endolaser photocoagulation, cryotherapy, drainage of subretinal fluid, scleral buckling, and/or removal of lens by same technique

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,589.25 / $12,589.25 / $12,589.25
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,288.25 / $1,479.11 / $2,951.21
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,000.00 / $1,659.59 / $2,290.87
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,584.89 / $1,584.89 / $1,584.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,479.11 / $1,995.26 / $2,570.40
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,479.11 / $2,344.23
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$12,589.25 / $12,589.25 / $12,589.25
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,258.93 / $1,698.24 / $3,890.45
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,202.26 / $1,737.80 / $2,344.23