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Arizona 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
$1,965.00 / $3,819.00 / $7,467.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$642.17 / $794.60 / $1,458.33
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$672.35 / $2,613.46 / $4,140.09
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$533.30 / $708.54 / $847.83
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$623.91 / $807.42 / $1,510.87
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$691.34 / $846.83 / $5,580.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$705.24 / $884.01 / $6,525.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,892.00 / $4,545.00 / $7,511.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$705.24 / $857.82 / $1,221.52