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Pennsylvania rates for HCPCS 15200

Fth/Gft Free W/Direct Closure Trunk 20 Sq Cm/<

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$772.23 / $3,426.89 / $8,017.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$580.09 / $725.64 / $1,229.93
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,736.00 / $4,444.00 / $15,949.31
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$827.89 / $859.13 / $1,494.29
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$587.48 / $820.08 / $1,398.17
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$998.03 / $1,283.18 / $1,326.36
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,309.64 / $4,309.64 / $6,169.02
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$806.44 / $806.44 / $806.44
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$875.55 / $3,839.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$586.67 / $783.41 / $2,293.52
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$759.10 / $759.10 / $800.50
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,134.14 / $1,134.14 / $1,134.14
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$614.64 / $837.38 / $1,480.60
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$652.90 / $662.47 / $813.51
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$652.90 / $793.96 / $869.00
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.00 / $2,884.00 / $6,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$705.09 / $906.80 / $1,556.67