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Pennsylvania rates for HCPCS 12055

Repair, intermediate, wounds of face, ears, eyelids, nose, lips and/or mucous membranes; 12.6 cm to 20.0 cm

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$470.38 / $2,543.00 / $8,017.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.92 / $397.68 / $658.00
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
$488.29 / $506.72 / $506.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$285.50 / $431.05 / $759.63
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$592.63 / $761.95 / $787.80
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$657.00 / $2,679.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.92 / $439.21 / $1,570.74
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$407.00 / $407.00 / $428.90
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$509.16 / $509.16 / $509.16
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$292.79 / $459.29 / $785.13
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$253.30 / $292.12 / $492.89
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.82 / $385.67 / $529.54
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
$365.11 / $517.70 / $851.81