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Pennsylvania rates for HCPCS 67113

Repair of complex retinal detachment (eg, proliferative vitreoretinopathy, stage C-1 or greater, diabetic traction retinal detachment, retinopathy of prematurity, retinal tear of greater than 90 degrees), with vitrectomy and membrane peeling, including, when performed, air, gas, or silicone oil tamponade, cryotherapy, endolaser photocoagulation, drainage of subretinal fluid, scleral buckling, and/or removal of lens

Facilitymedian $7,244 · 10th–90th $1,514–$14,4540%10%10th90th$7,244Professionalmedian $1,585 · 10th–90th $1,259–$3,8900%20%10th90th$1,585$10.0$50.0$200.0$1.0K$5.0K$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
$1,445.44 / $7,244.36 / $14,454.40
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,621.81 / $3,890.45
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,071.52 / $1,071.52 / $1,230.27
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,606.93 / $10,471.29 / $58,884.37
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$9,549.93 / $10,000.00 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,348.96 / $2,398.83
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $1,445.44 / $1,445.44
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,621.81 / $2,570.40
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,862.09
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,122.02 / $1,584.89 / $2,570.40
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$6,165.95 / $11,748.98 / $17,378.01
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,479.11 / $1,584.89 / $1,862.09
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $7,244.36 / $28,183.83
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,348.96 / $1,348.96 / $1,348.96
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,148.15 / $4,786.30 / $10,715.19
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,548.82 / $2,754.23
Oscar Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,897.79 / $8,709.64 / $10,715.19
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,348.96 / $3,467.37
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,288.25 / $1,621.81 / $1,737.80
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,258.93 / $1,621.81 / $1,621.81
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,344.23 / $5,754.40 / $16,982.44
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,148.15 / $1,513.56 / $2,691.53