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Pennsylvania rates for HCPCS 19294

Preparation of tumor cavity, with placement of a radiation therapy applicator for intraoperative radiation therapy (IORT) concurrent with partial mastectomy (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$831.76 / $2,691.53 / $8,317.64
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$5,011.87 / $8,511.38 / $77,624.71
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$660.69 / $2,344.23 / $8,317.64
Oscar Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$331.13 / $331.13 / $331.13
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$138.04 / $158.49 / $181.97
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$144.54 / $676.08 / $4,265.80