go back

Minnesota 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
$704.84 / $855.94 / $4,828.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$704.84 / $855.94 / $1,324.55
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,461.49 / $5,762.11 / $12,749.70
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,192.13 / $1,816.86 / $3,023.42
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,163.78 / $3,068.50 / $7,381.70
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,398.54 / $2,384.65 / $3,713.38
Health Partners
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,758.99 / $2,805.35 / $5,812.36
Health Partners
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,296.95 / $2,109.19 / $3,445.45
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$793.83 / $1,294.02 / $2,295.84
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,004.38 / $1,764.74 / $5,440.32
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,293.00 / $6,652.00 / $9,810.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,004.38 / $1,491.48 / $3,292.51