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Pennsylvania rates for HCPCS 0258U

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,852.10 / $13,781.30 / $15,177.80
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,947.75 / $2,940.00 / $3,123.75
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,866.50 / $2,866.50 / $2,866.50
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,460.41 / $4,774.63 / $10,981.08
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,713.50 / $17,713.50 / $17,713.50
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,858.75 / $4,961.25 / $9,077.25
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,655.82 / $15,177.80 / $15,177.80
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$2,411.90 / $3,123.75 / $15,177.80
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$5,439.00 / $5,512.50 / $7,350.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,560.73 / $4,643.59 / $12,194.96
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$17,713.50 / $17,713.50 / $17,713.50
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,675.00 / $3,675.00 / $4,042.50
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$3,675.00 / $3,675.00 / $4,042.50
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,543.50 / $2,205.00 / $5,145.00