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Pennsylvania rates for HCPCS 0122U

Sickle cell disease, microfluidic flow adhesion (P-Selectin), whole blood

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.02 / $1,815.83 / $2,173.33
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$278.89 / $426.25 / $447.30
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$410.46 / $410.46 / $410.46
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$345.87 / $683.69 / $1,746.17
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.63 / $604.63 / $755.79
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$242.07 / $310.48 / $712.52
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$542.02 / $1,973.36 / $2,173.33
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.36 / $447.30 / $2,173.33
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$367.72 / $700.76 / $1,746.17
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$604.63 / $604.63 / $755.79
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$526.23 / $526.23 / $578.85
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$463.08 / $526.23 / $578.85
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$315.74 / $315.74 / $631.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$221.02 / $315.74 / $915.64