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Pennsylvania rates for HCPCS 19301

Mastectomy, partial (eg, lumpectomy, tylectomy, quadrantectomy, segmentectomy);

Facilitymedian $5,754 · 10th–90th $1,445–$11,2200%10%10th90th$5,754Professionalmedian $794 · 10th–90th $525–$2,5120%10%20%10th90th$794$5.0$20.0$100.0$500.0$2.0K$10.0K$50.0K

Distribution of negotiated rates across all payers (price axis is log-scale). Facility and professional rates are different services and are charted separately. Need provider-level prices? Contact us.

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,445.44 / $5,623.41 / $10,964.78
Aetna
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$3,715.35 / $5,754.40 / $8,912.51
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$524.81 / $812.83 / $2,511.89
Ambetter
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$676.08 / $676.08 / $1,023.29
AmeriHealth
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,715.35 / $5,623.41 / $67,608.30
AmeriHealth
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $794.33
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$5,011.87 / $6,165.95 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $954.99 / $1,202.26
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$218.78 / $724.44 / $1,258.93
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,000.00 / $1,000.00 / $1,122.02
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$398.11 / $794.33 / $1,122.02
Highmark BCBS
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$4,073.80 / $9,120.11 / $17,378.01
Highmark BCBS
Facility/Professional
Facility
Modifier
22
Typical Low / Median / Typical High
$4,265.80 / $4,265.80 / $4,265.80
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Typical Low / Median / Typical High
$1,513.56 / $13,489.63 / $51,286.14
Highmark BCBS
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $831.76 / $1,000.00
Independence Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$3,388.44 / $4,570.88 / $32,359.37
Independence Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $794.33
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$758.58 / $3,890.45 / $12,302.69
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$549.54 / $724.44 / $1,445.44
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$512.86 / $977.24 / $1,380.38
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$645.65 / $645.65 / $758.58
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$588.84 / $660.69 / $758.58
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$1,659.59 / $3,981.07 / $12,589.25
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$389.05 / $676.08 / $1,318.26