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Pennsylvania rates for HCPCS 21079

Impression & Preparation Interim Obturator Prost

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,089.29 / $1,396.15 / $2,110.60
Capital Blue Cross
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,476.45 / $1,532.17 / $1,792.44
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,234.00 / $1,759.12 / $2,934.10
Emblem Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,723.85 / $2,284.01 / $2,977.57
Martin's Point
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,146.68 / $1,485.85 / $4,388.08
Oscar Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,975.80 / $1,975.80 / $3,484.90
Priority Health
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,234.00 / $1,779.41 / $3,036.91
UPMC Health Plan
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,144.89 / $1,376.71 / $1,486.48
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$1,455.67 / $1,898.64 / $3,013.56