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Pennsylvania rates for HCPCS 20900

Bone graft, any donor area; minor or small (eg, dowel or button)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$257.31 / $1,758.00 / $7,914.45
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.13 / $328.39 / $614.49
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$6,431.95 / $7,827.00 / $19,139.18
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$369.81 / $383.77 / $618.90
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$305.94 / $305.94 / $305.94
Cigna
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$30.59 / $30.59 / $30.59
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.14 / $407.96 / $742.10
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$445.12 / $596.98 / $768.84
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,289.83 / $11,210.28 / $21,058.44
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$171.67 / $175.40 / $278.43
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$267.39 / $1,736.50 / $7,914.45
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$168.50 / $353.57 / $785.74
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$536.70 / $536.70 / $921.00
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$305.94 / $305.94 / $305.94
Priority Health
Facility/Professional
Facility
Modifier
AS
Low / Median / High Price
$30.59 / $30.59 / $30.59
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$194.58 / $408.80 / $750.93
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$177.08 / $377.84 / $434.77
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$174.60 / $371.04 / $407.21
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,447.00 / $3,311.00 / $6,000.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$383.77 / $495.53 / $790.09