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Pennsylvania rates for HCPCS 15050

Pinch graft, single or multiple, to cover small ulcer, tip of digit, or other minimal open area (except on face), up to defect size 2 cm diameter

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$552.75 / $2,747.00 / $8,017.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$397.16 / $499.01 / $686.88
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
$575.19 / $596.89 / $596.89
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$402.13 / $564.79 / $931.76
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$696.57 / $895.59 / $925.73
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$832.00 / $3,077.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$399.64 / $525.94 / $2,406.04
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$394.50 / $394.50 / $415.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$771.02 / $771.02 / $771.02
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$416.75 / $570.70 / $1,007.10
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$348.23 / $448.69 / $575.16
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$428.79 / $477.78 / $616.99
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.00 / $650.00 / $4,300.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.86 / $619.32 / $1,026.11