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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
$1,202.26 / $4,786.30 / $8,317.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$20,417.38 / $21,379.62 / $57,543.99
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,023.29 / $3,801.89 / $8,317.64
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$467.74 / $467.74 / $2,754.23
UPMC Health Plan
Facility/Professional
Facility
Modifier
62
Low / Median / High Price
$2,570.40 / $2,570.40 / $2,570.40
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,174.90 / $1,995.26 / $5,011.87