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Pennsylvania rates for HCPCS 19369

Breast reconstruction; with bipedicled transverse rectus abdominis myocutaneous (TRAM) flap

Facilitymedian $5,370 · 10th–90th $1,047–$8,5110%10%20%10th90th$5,370Professionalmedian $1,905 · 10th–90th $1,698–$3,7150%50%10th90th$1,905$10.0$50.0$200.0$1.0K$5.0K$20.0K

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
$1,047.13 / $5,754.40 / $8,511.38
Aetna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,698.24 / $1,862.09 / $3,019.95
Capital Blue Cross
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$20,417.38 / $21,379.62 / $57,543.99
Capital Blue Cross
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,778.28 / $2,570.40 / $3,715.35
Cigna
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$363.08 / $2,454.71 / $3,981.07
Emblem Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,754.23 / $2,754.23 / $3,019.95
Geisinger
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,905.46 / $2,454.71 / $3,801.89
Martin's Point
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$831.76 / $3,981.07 / $8,317.64
Martin's Point
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,659.59 / $1,862.09 / $2,290.87
Oscar Health
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$2,398.83 / $3,162.28 / $4,365.16
UPMC Health Plan
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$691.83 / $691.83 / $1,949.84
UPMC Health Plan
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$691.83 / $1,905.46 / $1,995.26
United
Facility/Professional
Facility
Modifier
Typical Low / Median / Typical High
$2,089.30 / $2,818.38 / $6,309.57
United
Facility/Professional
Professional
Modifier
Typical Low / Median / Typical High
$1,621.81 / $2,238.72 / $4,073.80