go back

Pennsylvania rates for HCPCS 19303

Mastectomy, simple, complete

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,020.00 / $5,161.00 / $15,695.65
Aetna
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$4,129.54 / $8,012.57 / $30,997.12
AmeriHealth
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,343.84 / $4,579.60 / $56,320.04
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,083.53 / $13,624.75 / $30,419.50
Highmark BCBS
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$3,641.55 / $14,425.90 / $40,380.57
Independence Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$3,076.32 / $4,664.39 / $16,909.71
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,050.24 / $5,100.00 / $13,521.62
Martin's Point
Facility/Professional
Facility
Modifier
50
Low / Median / High Price
$4,273.46 / $7,957.61 / $30,997.12
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$937.47 / $937.47 / $1,005.20
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$2,155.00 / $3,475.00 / $6,000.00