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Pennsylvania rates for HCPCS 15733

Muscle, myocutaneous, or fasciocutaneous flap; head and neck with named vascular pedicle (ie, buccinators, genioglossus, temporalis, masseter, sternocleidomastoid, levator scapulae)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$937.96 / $3,494.00 / $7,629.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$888.38 / $937.96 / $2,401.85
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,025.33 / $1,674.73 / $1,916.74
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$894.60 / $1,184.45 / $2,061.28
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,217.66 / $1,565.57 / $1,617.84
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,806.47 / $7,732.91 / $11,401.55
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$937.96 / $4,068.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$894.86 / $1,071.88 / $3,494.00
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,419.90 / $1,419.90 / $1,419.90
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,161.46 / $1,161.46 / $1,161.46
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$947.22 / $1,184.45 / $2,197.28
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,005.23 / $1,005.23 / $1,160.01
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,005.23 / $1,009.47 / $1,160.01
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $3,475.00 / $6,368.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$944.98 / $1,150.83 / $2,073.04