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Pennsylvania rates for HCPCS 15757

Free skin flap with microvascular anastomosis

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,084.00 / $3,748.00 / $8,017.00
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,480.74
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,013.00 / $3,964.00 / $8,017.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,565.08 / $2,565.08 / $2,565.08
Priority Health
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$1,579.13 / $1,579.13 / $1,579.13
Priority Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$252.66 / $252.66 / $252.66
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,221.44 / $2,221.44 / $2,739.01
UPMC Health Plan
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$2,596.87 / $2,596.87 / $2,596.87
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,122.00 / $2,884.00 / $6,000.00