go back

Pennsylvania 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
$1,519.00 / $7,446.40 / $16,673.55
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,139.51 / $1,406.21 / $3,152.18
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,105.35 / $1,187.60 / $2,190.48
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,800.00 / $11,479.00 / $17,952.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,160.95 / $1,204.76 / $2,163.83
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.00 / $1,071.00 / $1,071.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$930.95 / $1,477.16 / $2,323.69
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$884.50 / $1,516.50 / $1,789.69
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,657.66 / $7,748.52 / $17,051.71
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,336.75 / $1,443.43 / $2,035.52
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,519.00 / $7,588.54 / $16,673.55
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,151.01 / $1,450.00 / $3,772.58
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,642.86 / $1,823.40 / $2,190.48
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,071.00 / $1,071.00 / $1,071.00
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$955.18 / $1,425.13 / $2,330.29
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,140.17 / $1,140.17 / $1,895.80
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,115.89 / $1,140.17 / $1,895.80
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,843.00 / $3,914.00 / $7,508.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.39 / $1,422.41 / $2,279.96