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Pennsylvania rates for HCPCS 20930

Allograft, morselized, or placement of osteopromotive material, for spine surgery only (List separately in addition to code for primary procedure)

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$121.26 / $2,240.00 / $7,175.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$108.31 / $121.26 / $448.80
Capital Blue Cross
Facility/Professional
Facility
Modifier
Low / Median / High Price
$13,531.00 / $27,840.00 / $46,296.00
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$91.65 / $95.11 / $97.96
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.69 / $131.69 / $131.69
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$111.89 / $145.72 / $235.63
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$282.23 / $347.40 / $487.48
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$506.57 / $2,763.02 / $5,594.60
Highmark BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.88 / $129.43 / $685.40
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$198.22 / $1,978.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$105.42 / $127.01 / $554.40
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$351.40 / $351.40 / $351.40
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$131.69 / $131.69 / $131.69
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$110.28 / $146.04 / $247.42
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$163.71 / $163.71 / $163.71
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$163.71 / $163.71 / $163.71
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$162.00 / $650.00 / $3,742.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$104.92 / $145.62 / $253.07