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Pennsylvania rates for HCPCS 0437T

Implantation of non-biologic or synthetic implant (eg, polypropylene) for fascial reinforcement of the abdominal wall (List separately in addition to code for primary procedure)

Facilitymedian $2,692 · 10th–90th $661–$8,3180%5%10th90th$2,692Professionalmedian $282 · 10th–90th $200–$3800%20%10th90th$282$50.0$200.0$1.0K$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
Typical Low / Median / Typical High
$831.76 / $2,691.53 / $8,317.64
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$208.93 / $275.42 / $371.54
Cigna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$323.59 / $501.19 / $870.96
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$323.59 / $436.52 / $1,230.27
Emblem Health
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $676.08
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$263.03 / $416.87 / $602.56
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$288.40 / $302.00 / $933.25
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$588.84 / $1,995.26 / $7,244.36
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $295.12 / $794.33
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$288.40 / $288.40 / $316.23
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$50.12 / $288.40 / $588.84
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$85.11 / $524.81 / $3,890.45
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$199.53 / $316.23 / $512.86