go back

New York 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
$1,023.29 / $3,630.78 / $9,332.54
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$645.65 / $794.33 / $2,041.74
Anthem BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,388.44 / $5,888.44 / $12,302.69
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$691.83 / $891.25 / $1,995.26
CDPHP
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $1,995.26 / $8,912.51
CDPHP
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,023.29 / $1,023.29 / $1,230.27
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,230.27 / $1,862.09 / $50,118.72
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$549.54 / $1,071.52 / $2,511.89
Emblem Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$549.54 / $831.76 / $2,238.72
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,122.02 / $1,288.25 / $2,137.96
Excellus BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $954.99 / $1,621.81
MVP Health Care
Facility/Professional
Facility
Modifier
Low / Median / High Price
$707.95 / $50,118.72 / $75,857.76
MVP Health Care
Facility/Professional
Professional
Modifier
Low / Median / High Price
$398.11 / $1,047.13 / $1,348.96
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,344.23 / $5,128.61 / $11,481.54
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$478.63 / $851.14 / $1,862.09
Univera
Facility/Professional
Facility
Modifier
Low / Median / High Price
$562.34 / $794.33 / $2,290.87
Univera
Facility/Professional
Professional
Modifier
Low / Median / High Price
$660.69 / $1,023.29 / $2,137.96