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Vitrectomy mechanical

CPT 67042 · negotiated-rate distribution across hospitals in TX

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Hospitals
35
Min
$1,127.36
Median
$3,998.74
Max
$6,615.00
Range multiplier
5.9×

By payer (50 payers with published rates)

PayerHosp.RatesMinMedianMaxRange×
Blue Cross Blue Shield29172$55.00$5,199.48$12,906234.7×
UnitedHealthcare2687$344.97$4,001.13$11,95834.7×
Aetna2246$962.46$2,794.49$15,60516.2×
Humana2541$962.46$3,718.40$14,88715.5×
Medicaid1839$962.46$1,105.89$1,881.012.0×
Medicare1136$2,002.17$4,019.54$4,707.222.4×
Cigna1428$1,049.17$7,043.00$11,81411.3×
Anthem BCBS224$1,085.30$1,559.34$2,002.171.8×
baylor scott & white health plan520$3,454.98$4,544.67$6,222.031.8×
Ambetter1111$2,002.17$7,697.09$8,121.384.1×
superior health plan610$1,533.49$1,571.83$3,904.322.5×
wellpoint48$1,671.50$3,385.49$5,099.473.1×
commercial | entrust | all plans88$7,792.22$9,254.75$10,3101.3×
commercial | community health choice | exchange77$4,014.30$5,880.50$5,884.021.5×
Medicare Advantage26$2,002.17$2,002.17$2,002.171.0×
american health plan66$3,818.66$3,904.32$3,959.481.0×
triwest55$3,636.82$3,718.40$3,770.931.0×
procare advantage55$3,818.66$3,904.32$3,959.481.0×
commercial | harris health | ers55$5,880.50$5,884.02$5,884.021.0×
commercial | kelseycare | all plans55$2,112.30$2,112.30$2,112.301.0×
commercial | kelseycare | exchange55$5,292.45$5,295.62$5,295.621.0×
commercial | nxhealth | all plans55$12,662$12,741$12,7491.0×
commercial | renaissance | all plans55$2,822.64$2,824.33$2,824.331.0×
commercial | superior health plan | all plans55$5,880.50$5,884.02$5,884.021.0×
prime health services55$3,809.93$3,895.40$3,950.431.0×
corvel55$3,809.93$3,895.40$3,950.431.0×
Molina55$1,610.16$1,610.16$3,904.322.4×
insurance services of lubbock44$6,157.14$6,157.14$6,157.141.0×
pdh/texas trust44$7,554.77$7,554.77$7,554.771.0×
scott & white44$6,043.82$6,043.82$6,043.821.0×
patoka valley tier 224$1,559.34$1,559.34$1,559.341.0×
care improvement44$3,777.39$3,777.39$3,777.391.0×
caprock44$9,443.46$9,443.46$9,443.461.0×
patoka valley tier 124$1,559.34$1,559.34$1,559.341.0×
wellmed44$3,777.39$3,777.39$3,777.391.0×
kempton group44$7,554.77$7,554.77$7,554.771.0×
90 degree benefits44$9,443.46$9,443.46$9,443.461.0×
mhs care connect24$1,085.30$1,085.30$1,085.301.0×
insurance management services44$6,157.14$6,157.14$6,157.141.0×
sedgwick33$5,437.05$5,561.10$5,637.541.0×
health partners open network23$2,250.25$2,250.25$6,369.792.8×
healthspring33$3,818.66$3,904.32$3,904.321.0×
injury management organization33$4,516.93$4,619.99$4,683.501.0×
wellpoint (fka amerigroup)12$1,533.49$2,681.72$3,829.952.5×
oklahoma complete health12$962.46$1,421.74$1,881.012.0×
encore exclusive22$1,559.34$1,559.34$1,559.341.0×
personalized care22$2,002.17$2,002.17$2,002.171.0×
corizon22$2,002.17$2,002.17$2,002.171.0×
commercial | ellwood | all plans22$11,688$11,688$11,6881.0×
secure horizons-pacificare22$2,002.17$2,002.17$2,002.171.0×

By hospital (top 200 by negotiated median, descending)

HospitalCitySTPayersGrossCashNeg minNeg medianNeg max
Baylor Orthopedic And Spine HospitalArlingtonTX3$55.00$6,615.00$10,329
San Angelo Community Medical CenterSan AngeloTX14$1,610.16$6,157.14$10,882
River Crest HospitalSan AngeloTX14$1,610.16$6,157.14$10,882
Shannon Medical CenterSan AngeloTX14$1,610.16$6,157.14$10,882
Big Spring State HospitalBig SpringsTX14$1,610.16$6,157.14$10,882
Scott And White Memorial HospitalTempleTX15$1,533.49$5,637.54$14,887
Hillcrest Baptist Medical CenterWacoTX14$1,533.49$5,606.12$14,887
Baylor Scott And White Mc At SunnyvaSunnyvaleTX2$3,704.25$5,512.00$8,020.00
Heritage Park Surgical HospitalShermanTX2$3,704.25$5,373.00$8,020.00
Baylor S&W Medical Center - PlanoPlanoTX14$1,533.49$4,564.34$15,605
Round Rock HospitalRound RockTX16$1,533.49$4,564.21$14,887
St. Joseph Regional Health CenterBryanTX9$1,073.68$4,371.54$12,662
College Station Medical CenterCollege StationTX9$1,073.68$4,371.54$12,662
Baylor University Medical CtrDallasTX16$1,533.49$4,276.16$15,605
Brazosport Regional Health SystemLake JacksonTX10$1,121.47$4,014.30$9,251.98
St Lukes Hospital At The VintageHoustonTX15$1,121.47$4,001.13$12,749
St. Lukes Sugar Land HospitalSugar LandTX13$1,121.47$4,001.13$9,257.52
St. Lukes The Woodlands HospitalThe WoodlandsTX14$1,121.47$3,998.74$12,741
Chi St Lukes Health Baylor Med CtrHoustonTX14$1,121.47$3,998.74$12,741
St. Lukes Lakeside HospitalThe WoodlandsTX14$1,121.47$3,981.52$9,257.52
St. Lukes Patients Medical CenterPasadenaTX8$1,065.40$3,920.33$6,006.00
Scott & White Cedar ParkCedar ParkTX1$3,818.66$3,818.66$3,818.66
Chi St Lukes Health Mem LivingstonLivingstonTX8$1,028.60$3,518.60$7,043.00
Chi St Lukes Health Memorial LufkinLufkinTX7$1,028.60$3,518.60$7,043.00
Trinity Regional Hospital SachseSachseTX8$7,152.00$5,721.60$1,024.83$3,428.74$10,557
Grimes St. Joseph Health CenterNavasotaTX3$1,073.68$2,928.72$11,958
Madison St. Joseph Health CenterMadisonvilleTX3$1,073.68$2,928.72$11,958
Wilson N Jones Regional Medical CtrShermanTX8$7,152.00$5,721.60$1,024.83$2,129.60$3,575.49
St Lukes Health Memorial San AugustSan AugustineTX4$1,073.68$1,701.07$7,043.00
Childrens Medical Center Of PlanoPlanoTX5$962.46$1,610.16$1,881.01
Ascension Seton BastropBastropTX18$344.97$1,559.34$2,464.05
Ascension Seton Shoal CreekAustinTX18$344.97$1,559.34$2,464.05
Pam Squared At Corpus ChristiCorpus ChrstiTX2$1,533.49$1,533.49$1,533.49
Acuity Hospital Of South TexasSan AntonioTX1$1,144.89$1,144.89$1,144.89
Burleson St. Joseph Health CenterCaldwellTX3$1,073.68$1,127.36$5,777.20

Median is taken across all payer × plan combinations the hospital publishes. Cash and gross are the latest snapshot values. Range multiplier (max ÷ min) is a quick way to see which hospitals or payers vary the most.