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Pennsylvania rates for HCPCS 12021

Tx Superficial Wound Dehiscence W/Packing

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.00 / $1,746.00 / $7,175.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$121.55 / $147.61 / $227.45
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,299.82 / $2,746.00 / $13,822.74
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.17 / $179.71 / $179.71
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$131.88 / $173.15 / $312.64
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$208.40 / $267.95 / $276.72
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$950.81 / $950.81 / $1,915.72
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$540.00 / $2,326.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$122.95 / $160.19 / $768.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$140.38 / $166.90 / $194.66
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$236.31 / $236.31 / $236.31
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$135.72 / $178.50 / $325.72
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$130.62 / $137.12 / $172.22
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$133.41 / $150.87 / $184.07
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.00 / $674.00 / $4,300.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.88 / $185.68 / $305.02