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Alaska rates for HCPCS 15572

Formation of direct or tubed pedicle, with or without transfer; scalp, arms, or legs

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,479.59 / $10,175.36 / $13,413.92
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,498.77 / $3,552.59 / $4,183.60
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,282.83 / $1,527.06 / $2,831.13
Moda Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,552.59 / $4,973.63 / $5,857.05
Moda Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,806.55 / $2,167.86 / $2,590.94
Premera BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,783.08 / $3,123.13 / $3,799.50
Providence
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,552.59 / $4,973.63 / $5,857.05
Providence
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,281.72 / $2,586.52 / $4,903.60
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$961.40 / $2,264.90 / $3,416.84