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Oklahoma 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
$1,000.00 / $3,742.00 / $12,600.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$666.95 / $794.60 / $875.95
BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,374.38 / $8,476.95 / $13,489.91
BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$697.55 / $937.91 / $1,142.86
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$753.79 / $976.94 / $1,229.99
Medica
Facility/Professional
Facility
Modifier
Low / Median / High Price
$734.73 / $1,050.00 / $5,975.00
Medica
Facility/Professional
Professional
Modifier
Low / Median / High Price
$757.85 / $950.75 / $6,525.60
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,157.00 / $4,054.00 / $7,077.94
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$730.46 / $901.13 / $1,320.46