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Kansas 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
$1,700.00 / $4,919.00 / $12,600.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$630.94 / $779.43 / $1,188.36
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$539.00 / $2,209.96 / $2,326.27
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$862.35 / $1,014.53 / $1,174.26
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$505.00 / $505.00 / $505.00
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$732.51 / $1,083.64 / $1,466.04
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$738.20 / $1,074.83 / $8,348.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$863.65 / $1,039.08 / $6,525.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,779.00 / $3,647.00 / $6,988.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$844.36 / $927.69 / $1,312.88