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Nebraska 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
$4,083.97 / $8,477.27 / $19,276.96
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$672.21 / $808.96 / $3,887.84
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,335.87 / $4,387.57 / $8,486.99
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$710.82 / $1,203.57 / $1,620.99
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$731.57 / $1,934.88 / $2,535.96
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$730.50 / $1,415.68 / $5,419.46
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,039.08 / $1,830.77 / $6,525.60
Midlands
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,347.00 / $1,974.43 / $3,628.99
Midlands
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,253.57 / $1,746.36 / $2,350.54
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,341.00 / $7,441.00 / $8,816.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,039.08 / $1,830.77 / $2,046.67