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Montana 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
$4,331.54 / $5,007.60 / $17,142.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,255.67 / $1,390.00 / $3,729.60
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$47,000.00 / $81,499.99 / $94,999.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,849.76 / $1,849.76 / $1,849.76
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,849.76 / $1,849.76 / $1,849.76
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,211.22 / $1,609.86 / $2,641.70
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,120.00 / $1,849.76 / $3,659.40
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,112.19 / $1,609.86 / $2,579.67
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,090.00 / $2,090.00 / $2,090.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,761.24 / $1,998.32 / $2,438.62