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Pennsylvania rates for HCPCS 01630

Anesthesia for open or surgical arthroscopic procedures on humeral head and neck, sternoclavicular joint, acromioclavicular joint, and shoulder joint; not otherwise specified

Facilitymedian $1,549 · 10th–90th $692$5,1290%10%20%10th90th$1,549$1.0K$2.0K$5.0K

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
QK
Typical Low / Median / Typical High
$691.83 / $691.83 / $812.83
Aetna
Facility/Professional
Facility
Modifier
QX
Typical Low / Median / Typical High
$1,548.82 / $2,691.53 / $5,128.61
Aetna
Facility/Professional
Facility
Modifier
QY
Typical Low / Median / Typical High
$1,096.48 / $1,096.48 / $1,096.48