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Pennsylvania rates for HCPCS 21030

Excision of benign tumor or cyst of maxilla or zygoma by enucleation and curettage

Insurance Carrier
Aetna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$574.00 / $2,679.00 / $8,017.00
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$345.22 / $436.68 / $663.49
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
$453.74 / $473.47 / $930.88
Cigna
Facility/Professional
Facility
Modifier
Low / Median / High Price
$612.22 / $612.22 / $612.22
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$370.68 / $525.65 / $918.98
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$539.02 / $716.55 / $931.04
Highmark BCBS
Facility/Professional
Facility
Modifier
Low / Median / High Price
$4,712.35 / $8,092.12 / $20,824.13
Martin's Point
Facility/Professional
Facility
Modifier
Low / Median / High Price
$934.00 / $3,120.00 / $8,017.00
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$354.37 / $483.80 / $1,426.58
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$529.50 / $529.50 / $1,115.30
Priority Health
Facility/Professional
Facility
Modifier
Low / Median / High Price
$612.22 / $612.22 / $612.22
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$372.07 / $528.88 / $933.35
UPMC Health Plan
Facility/Professional
Facility
Modifier
Low / Median / High Price
$351.23 / $429.20 / $470.78
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$349.90 / $437.61 / $476.14
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$1,334.00 / $2,824.00 / $5,678.00
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$426.04 / $571.02 / $916.40