go back

Pennsylvania rates for HCPCS 17004

Destruction (eg, laser surgery, electrosurgery, cryosurgery, chemosurgery, surgical curettement), premalignant lesions (eg, actinic keratoses), 15 or more lesions

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$152.60 / $1,234.00 / $6,012.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$89.70 / $155.38 / $321.45
Aetna
Facility/Professional
Professional
Modifier
22
Low / Median / High Price
$799.01 / $799.01 / $799.01
Ambetter
Facility/Professional
Professional
Modifier
Low / Median / High Price
$154.38 / $154.38 / $154.38
AmeriHealth
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.76 / $163.08 / $276.91
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,083.51 / $1,395.00 / $12,759.45
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$162.34 / $257.29 / $435.90
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.02 / $153.63 / $297.39
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$195.97 / $251.96 / $259.67
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$258.45 / $876.88 / $1,135.76
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$129.54 / $160.52 / $193.58
Highmark BCBS
Facility/Professional
Professional
Modifier
22
Low / Median / High Price
$227.74 / $227.74 / $227.74
Independence Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$153.76 / $163.08 / $276.91
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$379.00 / $1,569.00 / $7,197.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.29 / $160.85 / $332.53
Martin's Point
Facility/Professional
Professional
Modifier
22
Low / Median / High Price
$799.01 / $799.01 / $799.01
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$92.58 / $226.14 / $249.54
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$165.91 / $165.91 / $165.91
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$97.21 / $157.58 / $301.64
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$96.22 / $151.37 / $195.02
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$96.13 / $160.57 / $175.68
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.00 / $674.00 / $4,300.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$139.24 / $177.92 / $299.68