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Pennsylvania rates for HCPCS 12004

Simple Rpr Scalp/Neck/Ax/Genit/Trunk 7.6-12.5cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.45 / $1,284.00 / $4,083.75
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$64.45 / $114.07 / $326.52
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,083.51 / $1,395.00 / $12,759.45
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$130.40 / $135.32 / $210.55
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.92 / $129.16 / $235.23
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$157.72 / $202.80 / $209.91
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$213.20 / $657.74 / $860.89
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$127.72 / $127.72 / $127.72
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$194.09 / $1,284.00 / $5,750.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$66.92 / $123.52 / $360.70
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$74.37 / $207.60 / $207.60
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$125.45 / $125.45 / $125.45
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$72.50 / $130.37 / $263.32
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$71.63 / $126.92 / $176.26
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$71.63 / $126.92 / $137.34
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$265.18 / $577.00 / $3,742.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$115.45 / $157.06 / $251.72