go back

Indiana 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
$608.47 / $1,126.13 / $11,093.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$608.47 / $729.91 / $824.68
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,309.00 / $6,474.00 / $13,810.27
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$603.59 / $745.00 / $1,117.50
CareSource
Facility/Professional
Facility
Modifier
Low / Median / High Price
$594.72 / $866.26 / $1,083.23
CareSource
Facility/Professional
Professional
Modifier
Low / Median / High Price
$796.38 / $955.66 / $1,137.39
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,623.15 / $2,623.15 / $2,623.15
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$638.11 / $897.49 / $1,394.33
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,932.00 / $8,025.00 / $11,038.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$684.80 / $865.73 / $1,376.10